Provider Demographics
NPI:1144493545
Name:COKER, PATRICIA C
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:C
Last Name:COKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:FOLLY BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29439-0292
Mailing Address - Country:US
Mailing Address - Phone:843-792-7491
Mailing Address - Fax:
Practice Address - Street 1:151 RUTLEDGE AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-6850
Practice Address - Country:US
Practice Address - Phone:843-792-7491
Practice Address - Fax:843-792-3075
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2214225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics