| NPI | 1962635656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD KERRY WHITE Owner 843-200-1878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC 1008) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 949) |
| 225X00000X Occupational Therapist (Licence: SC 3218) | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |