Healthcare Provider Details

I. General information

NPI: 1164661609
Provider Name (Legal Business Name): PEDIATRIC THERAPY OF AIKEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 TOWN CREEK RD
AIKEN SC
29803-5841
US

IV. Provider business mailing address

181 TOWN CREEK RD
AIKEN SC
29803-5841
US

V. Phone/Fax

Practice location:
  • Phone: 803-642-0700
  • Fax: 803-642-0588
Mailing address:
  • Phone: 803-642-0700
  • Fax: 803-642-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL E MORLAN
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 803-642-0700