| NPI | 1962726117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN R LUCKIE Office Manager 843-571-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: SC 23765) |
| Additional Taxonomies | 111NR0400X (Licence: SC 2265) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2015-02-10 |