| NPI | 1275908352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MCQUILLEN Contracting Rep 864-482-0064 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2016-01-29 |