Etheredge, Tayvionna
Etheredge, Tayvionna is an individual health care provider with primary practice located at 100 Dreher Road Suite 100, West Columbia SC 29169. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Etheredge, Tayvionna can be contacted via phone (803) 525-7080.Contact Information
Primary practice address
100 Dreher Road Suite 100
West Columbia SC 29169
Phone: (803) 525-7080
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | PTA.5096 | South Carolina |
Profile Details
| NPI number | 1316633753 |
|---|---|
| LBN Legal business name | Etheredge, Tayvionna |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2023 |
| Last updated | Apr 17th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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