Individual
MRS. KELLY HEATH MCCOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1612 MARION ST, SUITE 113, COLUMBIA, SC 29201
(803) 253-6721
(803) 799-8177
Mailing address
5028 FURMAN AVE, COLUMBIA, SC 29206
(803) 782-0139
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4120
SC
Other
Enumeration date
06/26/2006
Last updated
09/12/2012
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