| NPI | 1750743506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RANDALL BARNES Partner 843-496-2573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: SC 4284) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: SC 4311) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |