=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386228773
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RELEVE PHYSICAL THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2021
-----------------------------------------------------
Last Update Date | 10/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 811 SPECKLED TEAL PATH
-----------------------------------------------------
City | AIKEN
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29803-6357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-398-4030
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 811 SPECKLED TEAL PATH
-----------------------------------------------------
City | AIKEN
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29803-6357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-398-4030
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ DOCTOR OF PHYSICAL THERAPY
-----------------------------------------------------
Name | DR. CARLY R RITTER
-----------------------------------------------------
Credential | PT, DPT, OCS
-----------------------------------------------------
Telephone | 765-398-4030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------