| NPI | 1851129977 |
|---|---|
| Former Legal Business Name | TIDAL CREEK PHYSICAL BEAUFORT |
| Entity Type | Organization |
| Authorized Contact | JEREMY CANNON PT A 843-379-3991 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2025-01-06 |