| NPI | 1487724217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW M. CLARK Owner 843-671-7342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-07-17 |