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General NPI Number Information
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NPI Number | 1316766900
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Entity Type | Organization
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Legal Business Name | CHARLESTON HAND THERAPY CENTER
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 2093 HENRY TECKLENBURG DR STE 200E
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City | CHARLESTON
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State | SC
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Zip | 29414-5742
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Country | US
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Telephone | 843-766-6494
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Fax | 843-766-6495
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Provider Business Mailing Address
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Address Line | 1483 TOBIAS GADSON BLVD STE 205B
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City | CHARLESTON
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State | SC
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Zip | 29407-4641
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Country | US
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Telephone | 843-766-6494
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Fax | 843-766-6495
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH FIELDS DE HERDER
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Credential | OTR L, CHT
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Telephone | 843-766-6494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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