Individual
MRS. PATTI KELLETT HARLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
125 COMMONWEALTH DR, GREENVILLE, SC 29615-4812
(864) 675-4393
Mailing address
5170 NORTH LAURENS RD, GRAY COURT, SC 29645
(864) 444-0580
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1699
SC
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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