MEDICARE: ABOUTKIDS-PEDIATRIC REHABILITATION SERVICES, INC.

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	2251P0200X	Pediatric Physical Therapist	294	SC

General Provider Information

NPI Number	:	1861441016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOUTKIDS-PEDIATRIC REHABILITATION SERVICES, INC.

Provider Business Mailing Address
First Line	:	374 CREPE MYRTLE DR
Second Line	:
City	:	GREER
State	:	SC
Zip	:	29651-7402
Country	:	US
Telephone Number	:	864-316-1536
Fax Number	:

Provider Business Practice Location Address
First Line	:	374 CREPE MYRTLE DR
Second Line	:
City	:	GREER
State	:	SC
Zip	:	29651-7402
Country	:	US
Telephone Number	:	864-316-1536
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MS. SUSAN L. SMITH
Credential	:	PT
Telephone Number	:	864-316-1536

Provider Enumeration Date	:	05/07/2006
Last Update Date	:	12/24/2007

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