Healthcare Provider Details

I. General information

NPI: 1962485672
Provider Name (Legal Business Name): ERIC MARK ACOBA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD NAVAL HOSPITAL BEAUFORT ATTN PROFESSIONAL AFFAIRS COORD
BEAUFORT SC
29902-6148
US

IV. Provider business mailing address

PO BOX 6216A NAVAL HOSPITAL BEAUFORT ATTN PROFESSIONAL AFFAIRS COORD
BEAUFORT SC
29902-6148
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-5577
  • Fax: 843-228-5196
Mailing address:
  • Phone: 843-228-5577
  • Fax: 843-228-5196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1426
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2783
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: