| NPI | 1306900766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE MAYNARD Pta 803-649-9975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC pta.1861) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |