| NPI | 1720052004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH GASSMAN SCHULTZ Administrator 843-766-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 200502773CC) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-08-22 |