Healthcare Provider Details

I. General information

NPI: 1639943756
Provider Name (Legal Business Name): ALTR PERFORMANCE & PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 LONG POINT RD STE 201
MOUNT PLEASANT SC
29464-8339
US

IV. Provider business mailing address

2402 TWO OAKS DR
CHARLESTON SC
29414-4824
US

V. Phone/Fax

Practice location:
  • Phone: 843-595-1055
  • Fax: 843-212-4894
Mailing address:
  • Phone: 843-595-1055
  • Fax: 843-212-4894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW BAGLEY
Title or Position: OWNER
Credential: PT, DPT, ATC
Phone: 843-595-1055