| NPI | 1588286082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORREY LOCKLEAR Owner/Manager 843-754-5147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2021-06-22 |