Provider Demographics
NPI:1649962754
Name:ETHERTON, ARLIE ALEXANDER (DPT, SCS)
Entity type:Individual
Prefix:DR
First Name:ARLIE
Middle Name:ALEXANDER
Last Name:ETHERTON
Suffix:
Gender:M
Credentials:DPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 HARRISON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7606
Mailing Address - Country:US
Mailing Address - Phone:864-214-0430
Mailing Address - Fax:
Practice Address - Street 1:404 HARRISON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-7606
Practice Address - Country:US
Practice Address - Phone:864-214-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC127672251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports