| NPI | 1073853412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY CARLSON Credentialing Manager 803-788-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: SC 6961) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |