Healthcare Provider Details

I. General information

NPI: 1417064429
Provider Name (Legal Business Name): HEALTHTRACKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 OLD WOODLANDS RD
COLUMBIA SC
29709
US

IV. Provider business mailing address

PO BOX 2539
COLUMBIA SC
29202
US

V. Phone/Fax

Practice location:
  • Phone: 803-695-5267
  • Fax: 803-695-5267
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateSC

VIII. Authorized Official

Name: MS. ANN M RARTON
Title or Position: OWNER
Credential: PT
Phone: 803-695-5267