Provider Demographics
NPI:1679203038
Name:WESTERN, HANNAH CHRISTINE (PT, DPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:CHRISTINE
Last Name:WESTERN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 ELIZABETH ST APT A
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-6645
Mailing Address - Country:US
Mailing Address - Phone:317-902-1879
Mailing Address - Fax:
Practice Address - Street 1:1051 JOHNNIE DODDS BLVD STE G
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3100
Practice Address - Country:US
Practice Address - Phone:843-654-9694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11337225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty