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General NPI Number Information
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NPI Number | 1376943555
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Entity Type | Organization
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Legal Business Name | RENEWAL REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 2885 W 5TH NORTH ST STE A2
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City | SUMMERVILLE
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State | SC
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Zip | 29483-9628
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Country | US
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Telephone | 843-970-7010
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Fax |
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Provider Business Mailing Address
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Address Line | 2885 W 5TH NORTH ST STE A2
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City | SUMMERVILLE
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State | SC
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Zip | 29483-9628
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Country | US
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Telephone | 843-970-7010
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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 | TAMARA GREEN
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Credential | PT
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Telephone | 843-813-1476
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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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