Provider Demographics
NPI:1588696850
Name:WADE-MIDDLETON, ERIN (PT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WADE-MIDDLETON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 WILLIAM HILTON PKWY STE 7
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-2703
Mailing Address - Country:US
Mailing Address - Phone:843-715-4060
Mailing Address - Fax:
Practice Address - Street 1:1012 WILLIAM HILTON PKWY STE 7
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-2703
Practice Address - Country:US
Practice Address - Phone:843-715-4060
Practice Address - Fax:843-715-4351
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00206948OtherRAILROAD PROVIDER NUMBER
SC187196OtherMEDCOST PROVIDER NUMBER
SCP00452756OtherRAILROAD PROVIDER NUMBER