Healthcare Provider Details

I. General information

NPI: 1962320374
Provider Name (Legal Business Name): GRACE E SEDBERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 LONG POINT RD UNIT M
MOUNT PLEASANT SC
29464-8362
US

IV. Provider business mailing address

620 LONG POINT RD UNIT M
MOUNT PLEASANT SC
29464-8362
US

V. Phone/Fax

Practice location:
  • Phone: 843-284-9275
  • Fax:
Mailing address:
  • Phone: 843-284-9275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13430
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: