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General NPI Number Information
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NPI Number | 1194520106
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Entity Type | Organization
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Legal Business Name | FYZICAL LLC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 2048 SAM RITTENBERG BLVD STE 3
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City | CHARLESTON
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State | SC
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Zip | 29407-4673
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Country | US
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Telephone | 239-989-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 2181 WAPPOO DR
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City | CHARLESTON
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State | SC
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Zip | 29412-2090
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Country | US
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Telephone | 239-989-7575
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. MICHAEL LAWRENCE BADINO
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Credential |
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Telephone | 239-989-7575
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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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