| NPI | 1861475857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A LOWE Administrator 843-669-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 4958) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: SC 361) |
| 235Z00000X Speech-Language Pathologist, (Licence: SC 3388) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-08-22 |