| NPI | 1457961963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY WAYNE NICHOLS Physical Therapist 803-924-3581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |