Fetzko, Madeline M

Fetzko, Madeline M is an individual health care provider with primary practice located at 210 Village Center Blvd Ste 200 , Myrtle Beach SC 29579-6706. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Fetzko, Madeline M can be contacted via phone (843) 353-3460.

Contact Information

Primary practice address
210 Village Center Blvd Ste 200 Myrtle Beach SC 29579-6706
Phone: (843) 353-3460
Fax: (843) 353-3461
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 05790 Maryland

Profile Details

NPI number 1992718027
LBN Legal business name Fetzko, Madeline M
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Jul 20th, 2022 - about 2 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1992718027 NPPES
Maryland Other 05790 LICENCE NUMBER

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