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Individual

DR. WILLIAM OLIVER REESIDE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
109 PARK PLACE CT, LEXINGTON, SC 29072-6690
(803) 933-6784
Mailing address
1910 BLANDING ST, COLUMBIA, SC 29201-3520
(803) 256-4107

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12762
NC
225100000X
Physical Therapist
6268
SC
2251X0800X
Orthopedic Physical Therapist
Primary
6268
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12762
NC BOARD OF PT EXAMINERS
NC
01
6268
SC BOARD OF PT EXAMINERS
SC
Enumeration date
08/27/2010
Last updated
02/05/2021
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