Healthcare Provider Details

I. General information

NPI: 1356773873
Provider Name (Legal Business Name): DRAYER PHYSICAL THERAPY-SOUTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 02/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WILLIAM POPE DR STE 5
BLUFFTON SC
29909-7550
US

IV. Provider business mailing address

10 WILLIAM POPE DR SUITE 3
BLUFFTON SC
29909-7549
US

V. Phone/Fax

Practice location:
  • Phone: 843-705-9440
  • Fax: 843-705-9445
Mailing address:
  • Phone: 843-705-9440
  • Fax: 843-705-9445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LUKE A DRAYER
Title or Position: CHAIRMAND & CEO
Credential:
Phone: 717-220-2100