Healthcare Provider Details

I. General information

NPI: 1538683222
Provider Name (Legal Business Name): JOSEPH TIMOTHY SCHRIVER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 STOCKDALE ST STE B
MT PLEASANT SC
29466-7125
US

IV. Provider business mailing address

5111 N RHETT AVE
NORTH CHARLESTON SC
29405-4219
US

V. Phone/Fax

Practice location:
  • Phone: 843-375-5448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8721
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: