Healthcare Provider Details

I. General information

NPI: 1033188396
Provider Name (Legal Business Name): JVB PHYSICAL THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 MULBERRY ST
CHARLESTON SC
29407-5816
US

IV. Provider business mailing address

1635 MULBERRY ST
CHARLESTON SC
29407-5816
US

V. Phone/Fax

Practice location:
  • Phone: 843-364-5089
  • Fax: 843-763-0229
Mailing address:
  • Phone: 843-364-5089
  • Fax: 843-763-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number2723
License Number StateSC

VIII. Authorized Official

Name: MRS. JENNIFAYE VERDINA GREENE
Title or Position: PRESIDENT/OWNER PHYSICAL THERAPIST
Credential: PT, MS, NCS
Phone: 843-364-5089