Individual
SUSAN D DEMERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
PIVITAL THERAPY, 1020 GROVE ROAD, GREENVILLE, SC 29605
(864) 455-2319
(864) 455-2340
Mailing address
255 ENTERPRISE BLVD, SUITE 250, GREENVILLE, SC 29615-6300
(864) 454-0888
(864) 454-1130
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4177
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213663
MEDCOST
SC
01
—
9799717
CIGNA INTERNAL GRP #
SC
05
—
TH1665
—
SC
Enumeration date
06/28/2006
Last updated
07/09/2007
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