Healthcare Provider Details
I. General information
NPI: 1669489910
Provider Name (Legal Business Name): JAMES ISLAND PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
320 SEAPORT LN UNIT 3328
MT PLEASANT SC
29464-3785
US
IV. Provider business mailing address
500 WESTOVER DR # 34841
SANFORD NC
27330-8941
US
V. Phone/Fax
- Phone: 843-478-5478
- Fax:
- Phone: 843-478-5478
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | PT3683 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | PT5322 |
| License Number State | SC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRANDON
CRAIG
DUFFIE
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT, ATC
Phone: 843-478-5478