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Anne Renee Hereda, PT

Physical Therapist in Myrtle Beach, SC. Individual provider (NPI-1).

NPI number1275043390
StatusActive
Last updated in NPPESOct 3, 2017

Details

NPI
1275043390
Entity type
Individual (NPI-1)
Name
Anne Renee Hereda
Credential
PT
Sex
Female
Sole proprietor
No
Enumeration date
Oct 3, 2017
Last updated
Oct 3, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist7652SCYes

Practice location

8161 Rourk St
Myrtle Beach, SC 29572-4128

Phone 843-449-3685 · Fax 843-449-2746

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

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