Individual
KATHLEEN JO PEAVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
511 W BUTLER RD, GREENVILLE, SC 29607-4890
(864) 757-9918
(864) 757-9921
Mailing address
217 DEVON DR, MAULDIN, SC 29662-1915
(317) 902-6244
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
7092
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH3018
—
SC
Enumeration date
08/30/2013
Last updated
01/29/2019
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