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NPI Code Detail

MEDICARE: CARLOS O'NEAL PT

MEDICARE:   CARLOS  O'NEAL  PT
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
1225100000XPhysical Therapist10600SC

General Provider Information

NPI Number : 1154999472
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS O'NEAL PT
Provider Business Mailing Address
First Line : 141 ATRIUM WAY
Second Line :
City : COLUMBIA
State : SC
Zip : 29223-6301
Country : US
Telephone Number : 803-957-0404
Fax Number : 803-957-0468
Provider Business Practice Location Address
First Line : 1787 S LAKE DR STE H
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-6736
Country : US
Telephone Number : 803-957-0404
Fax Number : 803-957-0468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2021
Last Update Date : 06/14/2021

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Directions to “ CARLOS O'NEAL PT” Practice Location

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