Individual
DOREEN TIREVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3409 SALTERBECK CT, MOUNT PLEASANT, SC 29466-7117
(816) 216-6800
Mailing address
3409 SALTERBECK CT, MOUNT PLEASANT, SC 29466-7117
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5974
SC
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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