Provider Demographics
NPI:1124070974
Name:MCCREA, WILLIAM THOMAS (CPO)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:MCCREA
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:TOMMY
Other - Middle Name:
Other - Last Name:MCCREA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:303 W ALEXANDER AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4078
Mailing Address - Country:US
Mailing Address - Phone:864-942-7001
Mailing Address - Fax:864-942-7008
Practice Address - Street 1:303 W ALEXANDER AVE
Practice Address - Street 2:SUITE H
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4078
Practice Address - Country:US
Practice Address - Phone:864-942-7001
Practice Address - Fax:864-942-7008
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist