Provider Demographics
NPI:1063729176
Name:GEORGE, WILLIAM BRADLEY (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRADLEY
Last Name:GEORGE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 WILLIAM HILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3442
Mailing Address - Country:US
Mailing Address - Phone:843-842-3222
Mailing Address - Fax:843-842-3202
Practice Address - Street 1:811 WILLIAM HILTON PKWY
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29928-3442
Practice Address - Country:US
Practice Address - Phone:843-842-3222
Practice Address - Fax:843-842-3202
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6276OtherPT LICENSE NUMBER