| NPI | 1972770733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH WILLIAMSON Credentialing Specialist 843-804-9479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2022-08-03 |