Individual
MR. HARRELL EDWARD WIMBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT CSCS
Contact information
Practice address
1706 NURSERY HILL RD, COLUMBIA, SC 29212-1407
(803) 781-9989
(803) 781-9989
Mailing address
1706 NURSERY HILL RD, COLUMBIA, SC 29212-1407
(803) 781-9989
(803) 781-9989
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
892
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH0008
—
SC
Enumeration date
07/21/2006
Last updated
07/09/2007
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