Individual
KAITLYN EARGLE GREENTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
113 E MAIN ST, LEXINGTON, SC 29072-3449
(803) 704-4759
Mailing address
113 E MAIN ST, LEXINGTON, SC 29072-3449
(803) 704-4759
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4984
SC
225X00000X
Occupational Therapist
Primary
7884
SC
Other
Enumeration date
09/22/2022
Last updated
04/20/2026
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