| NPI | 1811218423 |
|---|---|
| Doing Business As | SPINE & SPORT CHARLESTON |
| Entity Type | Organization |
| Authorized Contact | SEBRENA CAROLIN HOLMES GIBSON VP A 877-826-1509 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-06-17 |