| NPI | 1285641308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON THAYER Owner 843-216-0290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2015-06-23 |