| NPI | 1942414305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BECKHAM Credentialing Coordinator 843-884-7880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2009-06-12 |