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General NPI Number Information
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NPI Number | 1285932772
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Entity Type | Organization
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Legal Business Name | KBR PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 314 ALBRIGHTON WAY
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City | MONCKS CORNER
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State | SC
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Zip | 29461-8858
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Country | US
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Telephone | 843-810-8501
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Fax |
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Provider Business Mailing Address
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Address Line | 314 ALBRIGHTON WAY
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City | MONCKS CORNER
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State | SC
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Zip | 29461-8858
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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 | PHYSICAL THERAPIST
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Name | KAREN ROBINSON
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Credential | MRS, PT
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Telephone | 843-810-8501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 5313
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License Number State | SC
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