DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TAYVIONNA ETHEREDGE

Active

Physical Medicine & Rehabilitation · WEST COLUMBIA, SC

Registration Details

NPI Number
1316633753
Provider Type
Individual
Gender
Female
NPI Issued
Apr 17, 2023 (3.0538923676916 yrs)
Last Updated
Apr 17, 2023
License
PTA.5096 (SC)

Practice Information

Address
100 DREHER ROAD
SUITE 100
WEST COLUMBIA, SC, 29169
Browse SC providers · Browse ZIP 29169
Phone
8035257080
Primary Specialty
Physical Medicine & Rehabilitation
208100000X

Other Physical Medicine & Rehabilitation Providers in WEST COLUMBIA, SC

Name Credential NPI
WILLIAM RANDAL WESTERKAM MD 1376597070
DR. JOHN EVANS STAVRAKOS MD 1063426724
MR. KENNETH DIXON ACKER JR. 1508961020
DR. TIFFANY NICOLE HOWARD MD 1003007055
JACQUELYN F VAN DAM MD 1477703940
MAEGHAN EDGE PTA 1437930237
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.