Individual
ANTHONY FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1912 FRUITWOOD AVE, CHARLESTON, SC 29414-6223
(843) 729-1119
Mailing address
1912 FRUITWOOD AVE, CHARLESTON, SC 29414-6223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4591
SC
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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