Individual
DEBORAH FRIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
990 COLUMBIA AVE, IRMO, SC 29063-2884
(803) 999-5693
Mailing address
21 FAVERSHAM CT, COLUMBIA, SC 29229-7380
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
307
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
307
PTA
SC
Enumeration date
05/23/2017
Last updated
05/23/2017
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