Healthcare Provider Details

I. General information

NPI: 1194520106
Provider Name (Legal Business Name): FYZICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2048 SAM RITTENBERG BLVD STE 3
CHARLESTON SC
29407-4673
US

IV. Provider business mailing address

2181 WAPPOO DR
CHARLESTON SC
29412-2090
US

V. Phone/Fax

Practice location:
  • Phone: 239-989-7575
  • Fax:
Mailing address:
  • Phone: 239-989-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL LAWRENCE BADINO
Title or Position: OWNER/CEO
Credential:
Phone: 239-989-7575