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General NPI Number Information
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NPI Number | 1073371514
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Entity Type | Organization
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Legal Business Name | TESSERA PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/11/2024
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 840 MEETING ST UNIT B1
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-7306
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Country | US
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Telephone | 803-862-0042
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Fax | 803-862-0041
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Provider Business Mailing Address
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Address Line | 840 MEETING ST UNIT B1
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-7306
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | NICOLE TESSIER
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Credential | DPT
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Telephone | 727-831-1314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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