| NPI | 1629659586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE PNIEWSKI COO/Practice Site Manager 803-474-4534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-04-21 |