| NPI | 1073334090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH STOUT Owner/Physical Therapist 864-590-1867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2024-10-22 |
| Last Update Date | 2024-10-22 |