| NPI | 1346859881 |
|---|---|
| Doing Business As | WAVE PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID BLACKWELL Owner 843-437-8184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-07-30 |