Provider Demographics
NPI:1447819453
Name:BEMOWSKI, KACI MARIAH (PT, DPT)
Entity type:Individual
Prefix:
First Name:KACI
Middle Name:MARIAH
Last Name:BEMOWSKI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KACI
Other - Middle Name:MARIAH
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1076 RIBAUT RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5490
Mailing Address - Country:US
Mailing Address - Phone:843-525-0045
Mailing Address - Fax:843-525-0826
Practice Address - Street 1:1076 RIBAUT RD STE 102
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5490
Practice Address - Country:US
Practice Address - Phone:843-525-0045
Practice Address - Fax:843-525-0826
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11173225100000X
ALPTH9374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist