| NPI | 1639943756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BAGLEY Owner 843-595-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2025-07-21 |