Healthcare Provider Details

I. General information

NPI: 1720295793
Provider Name (Legal Business Name): PALMETTO BONE AND JOINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 02/13/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 KINARD ST
NEWBERRY SC
29108
US

IV. Provider business mailing address

2704 KINARD ST
NEWBERRY SC
29108
US

V. Phone/Fax

Practice location:
  • Phone: 803-321-6254
  • Fax: 803-321-6259
Mailing address:
  • Phone: 803-321-6254
  • Fax: 803-321-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateSC

VIII. Authorized Official

Name: WILLIAM S. OWENS JR.
Title or Position: OWNER
Credential: MD
Phone: 803-321-6254