Healthcare Provider Details

I. General information

NPI: 1922247253
Provider Name (Legal Business Name): MATRIX REHABILITATION SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 RIVERFRONT LN.
SIMPSONVILLE SC
29681
US

IV. Provider business mailing address

P.O. BOX 26511
GREENVILLE SC
29616
US

V. Phone/Fax

Practice location:
  • Phone: 864-675-6579
  • Fax: 864-675-6579
Mailing address:
  • Phone: 864-451-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VIII. Authorized Official

Name: MR. BOBBY JEFFREY HAMPTON
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 864-451-2727