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General NPI Number Information
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NPI Number | 1548089139
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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 RM 2B24
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City | CHARLESTON
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State | SC
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Zip | 29414-5741
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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 |
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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