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General NPI Number Information
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NPI Number | 1245303643
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Entity Type | Organization
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Legal Business Name | LOWCOUNTRY PHYSICAL THERAPY ASSOCIATES LLC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 8 FARMFIELD AVE SUITE B
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City | CHARLESTON
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State | SC
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Zip | 29407-7779
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Country | US
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Telephone | 843-266-9200
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Fax | 843-266-9201
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Provider Business Mailing Address
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Address Line | 8 FARMFIELD AVE SUITE B
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City | CHARLESTON
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State | SC
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Zip | 29407-7779
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Country | US
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Telephone | 843-266-9200
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Fax | 843-266-9201
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Authorized Official
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Title or Position | OWNER PHYSICAL THERAPIST
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Name | AMANDA HEYBOER
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Credential | M.P.T.
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Telephone | 843-266-9200
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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 | 2183
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3876
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License Number State | SC
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