Kluckhohn, Nicole Sanfacon

Kluckhohn, Nicole Sanfacon is an individual health care provider with primary practice located at 225 Ballyhoo Ct , Greer SC 29651-4914. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Kluckhohn, Nicole Sanfacon can be contacted via phone (864) 907-5324.

Contact Information

Primary practice address
225 Ballyhoo Ct Greer SC 29651-4914
Phone: (864) 907-5324
Fax: (833) 615-4258
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 3529 South Carolina

Profile Details

NPI number 1740385616
LBN Legal business name Kluckhohn, Nicole Sanfacon
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Aug 18th, 2020 - about 5 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 1740385616 NPPES
South Carolina MEDICAID TH1787

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