TIFFANY RENEE GODBOLT

LAKE CITY, SC
NPI1952747107
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: SC  1980)
Enumeration Date2013-05-15
Last Update Date2013-06-03
Business Address
Ms. TIFFANY RENEE GODBOLT P.T.A.
318 E MAIN ST
LAKE CITY, SC 29560-2116
Phone number: 843-374-3353
Mailing Address
Ms. TIFFANY RENEE GODBOLT P.T.A.
1057 KINNEY CT
SELLERS, SC 29592-8001
Phone number: 843-758-4738
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