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General NPI Number Information
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NPI Number | 1346925559
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Entity Type | Organization
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Legal Business Name | PIVOT PELVIC HEALTH PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 147 VERA RD STE D
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City | LEXINGTON
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State | SC
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Zip | 29072-3756
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Country | US
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Telephone | 803-816-1267
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Fax |
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Provider Business Mailing Address
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Address Line | 314 TUFTON CT
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City | CAYCE
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State | SC
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Zip | 29033-2751
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Country | US
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Telephone | 330-329-7480
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | DR. JENNIFER HINES
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Credential |
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Telephone | 330-329-7480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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