Healthcare Provider Details

I. General information

NPI: 1972758662
Provider Name (Legal Business Name): LOWCOUNTRY REHABILITATION LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2008
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 BELLS HWY
WALTERBORO SC
29488-6815
US

IV. Provider business mailing address

5120 WOODWAY DR SUITE 10001
HOUSTON TX
77056-1723
US

V. Phone/Fax

Practice location:
  • Phone: 843-538-2055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MICHAEL LANG
Title or Position: PRESIDENT OF GP
Credential:
Phone: 713-572-9000