Provider Demographics
NPI:1306164173
Name:CARVER, JAMIE MAKAYLA (PT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MAKAYLA
Last Name:CARVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:MAKAYLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1310 GARLINGTON RD
Mailing Address - Street 2:A
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615
Mailing Address - Country:US
Mailing Address - Phone:864-288-2998
Mailing Address - Fax:864-288-3522
Practice Address - Street 1:1310 GARLINGTON RD STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5485
Practice Address - Country:US
Practice Address - Phone:864-288-2998
Practice Address - Fax:864-288-3522
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6158225100000X, 225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand