Healthcare Provider Details

I. General information

NPI: 1497583199
Provider Name (Legal Business Name): PULSE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 SUNROSE LN
JOHNS ISLAND SC
29455-3284
US

IV. Provider business mailing address

2770 SUNROSE LN
JOHNS ISLAND SC
29455-3284
US

V. Phone/Fax

Practice location:
  • Phone: 845-642-2844
  • Fax:
Mailing address:
  • Phone: 845-642-2844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JUAN MENDEZ III
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 972-469-0000