| NPI | 1093416802 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | COURTNEY ANDREWS Owner 803-530-2816 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics | 
| Enumeration Date | 2023-03-17 | 
| Last Update Date | 2023-03-17 |