Healthcare Provider Details

I. General information

NPI: 1992117972
Provider Name (Legal Business Name): LIVE BETTER THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 VILLAGE CREEK LN
MOUNT PLEASANT SC
29464-3186
US

IV. Provider business mailing address

PO BOX 2367
MOUNT PLEASANT SC
29465-2367
US

V. Phone/Fax

Practice location:
  • Phone: 843-607-0982
  • Fax: 843-278-9155
Mailing address:
  • Phone: 843-607-0982
  • Fax: 843-278-9155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN LEWIS
Title or Position: PRESIDENT
Credential:
Phone: 843-607-0982