| NPI | 1104600790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH RAVEN KENNEDY Physical Therapist Assistant 843-473-0751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-08-23 |