Healthcare Provider Details

I. General information

NPI: 1215764022
Provider Name (Legal Business Name): MALORY ROSE STREHL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 EWALL ST STE 259
MOUNT PLEASANT SC
29464-3062
US

IV. Provider business mailing address

3229 W MONTAGUE AVE UNIT 3221
NORTH CHARLESTON SC
29418-7944
US

V. Phone/Fax

Practice location:
  • Phone: 843-972-7199
  • Fax: 843-203-0049
Mailing address:
  • Phone: 262-290-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12507
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: