| NPI | 1407825706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE BUNDRICK FREDERICKS Physical Therapist 843-906-5210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 1623) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2020-08-22 |