Provider Demographics
NPI:1861577397
Name:WORKMAN, MARLENE RILEY (RPT, MHS)
Entity type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:RILEY
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:RPT, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 SLAB LANDING RD.
Mailing Address - Street 2:
Mailing Address - City:COPE
Mailing Address - State:SC
Mailing Address - Zip Code:29038-0206
Mailing Address - Country:US
Mailing Address - Phone:803-535-0858
Mailing Address - Fax:
Practice Address - Street 1:119 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2407
Practice Address - Country:US
Practice Address - Phone:803-536-5509
Practice Address - Fax:803-536-4104
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist