Provider Demographics
NPI:1215949003
Name:HUMMEL PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:HUMMEL PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:864-882-7965
Mailing Address - Street 1:135 EAGLES NEST PARK
Mailing Address - Street 2:SUITE E
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-2766
Mailing Address - Country:US
Mailing Address - Phone:864-882-7965
Mailing Address - Fax:864-882-7967
Practice Address - Street 1:135 EAGLES NEST PARK
Practice Address - Street 2:SUITE E
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-2766
Practice Address - Country:US
Practice Address - Phone:864-882-7965
Practice Address - Fax:864-882-7967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0632Medicaid
SC1933Medicare PIN