MEDICARE: VITAL ENERGY OCCUPATIONAL THERAPY & WELLNESS CTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9433	OTHER	SC	MEDICARE PTAN

General Provider Information

NPI Number	:	1134468127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL ENERGY OCCUPATIONAL THERAPY & WELLNESS CTR

Provider Business Mailing Address
First Line	:	121 CLEARVIEW DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-8304
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4114 FOREST DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4316
Country	:	US
Telephone Number	:	803-359-1551
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MGR
Name	:	SUZY SHAY
Credential	:
Telephone Number	:	803-359-1551

Provider Enumeration Date	:	02/11/2013
Last Update Date	:	02/11/2013

Similar Medicare Providers

1992394779 — HUMAN PERFORMANCE AND REHABILITATION CENTERS, LLC
Practice Location Address:

4114 FOREST DR
COLUMBIA, SC
29204-4316

Practice Phone: 803-939-2213
Practice Fax: 803-939-2214

1336838648 — MS. HEIDI LYNN DORSEY PMHNP-BC
Practice Location Address:

3600 FOREST DR STE 302
COLUMBIA, SC
29204-4057

Practice Phone: 843-501-1099
Practice Fax: 843-405-2040

1558246397 — BUTTERFLY STEPS, LLC
Practice Location Address:

2161 BARHAMVILLE RD
COLUMBIA, SC
29204-1121

Practice Phone: 803-261-6755
Practice Fax:

1275536245 — DR. EDGAR HAROLD PEACOCK JR. D.D.S.
Practice Location Address:

2750 LAUREL ST , STE 202
COLUMBIA, SC
29204-2024

Practice Phone: 803-256-9268
Practice Fax: 803-256-0084

1770586588 — SAMUEL M WILLIS JR. MD
Practice Location Address:

2739 LAUREL ST , 1-A
COLUMBIA, SC
29204-2028

Practice Phone: 803-799-4800
Practice Fax: 803-256-0397

1114921491 — DR. KAREN EVANGELINE JOHNSON DDS, MHS
Practice Location Address:

2757 LAUREL ST STE 1
COLUMBIA, SC
29204-2037

Practice Phone: 803-606-9011
Practice Fax: 803-630-1529

Directions to “VITAL ENERGY OCCUPATIONAL THERAPY & WELLNESS CTR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.