Healthcare Provider Details

I. General information

NPI: 1841324381
Provider Name (Legal Business Name): SEA ISLAND REHABILITATION, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 09/11/2025
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 10TH ST
PORT ROYAL SC
29935-2310
US

IV. Provider business mailing address

1004 10TH ST
PORT ROYAL SC
29935-2310
US

V. Phone/Fax

Practice location:
  • Phone: 843-310-9690
  • Fax: 843-379-5742
Mailing address:
  • Phone: 843-310-9690
  • Fax: 843-379-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTEN POLLARD THORPE
Title or Position: OWNER
Credential: OTR-L
Phone: 843-310-9690