Healthcare Provider Details

I. General information

NPI: 1083775647
Provider Name (Legal Business Name): ACCELERATED PHYSICAL THERAPY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 NE MAIN ST STE B
SIMPSONVILLE SC
29681-2063
US

IV. Provider business mailing address

877 NE MAIN ST STE B
SIMPSONVILLE SC
29681-2063
US

V. Phone/Fax

Practice location:
  • Phone: 864-962-8016
  • Fax: 864-962-8116
Mailing address:
  • Phone: 864-962-8016
  • Fax: 864-962-8116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROGER BACHOUR
Title or Position: PRESIDENT
Credential: PT
Phone: 864-233-4477