Individual
KAREN GODLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1076 RIBAUT RD, SUITE 102, BEAUFORT, SC 29902
(843) 521-1970
Mailing address
11 MEADOWLARK ST, BEAUFORT, SC 29907-1900
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
3377
SC
225200000X
Physical Therapy Assistant
Primary
49388
CA
225200000X
Physical Therapy Assistant
PTA1463
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3377
LICENSE
SC
Enumeration date
06/09/2016
Last updated
07/06/2018
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