| NPI | 1861964520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY LEANN MANASCO Physical Therapist 843-364-1747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |