Healthcare Provider Details
I. General information
NPI: 1619000726
Provider Name (Legal Business Name): THERAPY CENTERS OF SOUTH CAROLINA, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4115 DORCHESTER ROAD SUITE 100
CHARLESTON SC
29405
US
IV. Provider business mailing address
5080 SPECTRUM DRIVE SUITE 1200 WEST TOWER
ADDISON TX
75001
US
V. Phone/Fax
- Phone: 843-554-6737
- Fax: 843-554-3356
- Phone: 800-232-3550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
HASSETT
Title or Position: SENIOR VP / CHIEF MEDICAL OFFICER
Credential: DO
Phone: 972-364-8000