Healthcare Provider Details

I. General information

NPI: 1477508455
Provider Name (Legal Business Name): ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4012 POSTAL WAY SUITE C
MYRTLE BEACH SC
29579-3185
US

IV. Provider business mailing address

4012 POSTAL WAY SUITE C
MYRTLE BEACH SC
29579-3185
US

V. Phone/Fax

Practice location:
  • Phone: 843-903-4940
  • Fax:
Mailing address:
  • Phone: 843-903-4940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DARGAN ERVIN
Title or Position: DIRECTOR OF ADMINISTRATION & CLIENT
Credential: P.T.
Phone: 843-293-7713