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General NPI Number Information
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NPI Number | 1548774409
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Entity Type | Organization
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Legal Business Name | GREENVILLE PROAXIS THERAPY LLC
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 333 S PINE ST
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City | SPARTANBURG
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State | SC
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Zip | 29302-2622
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Country | US
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Telephone | 864-515-7580
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Fax | 864-515-7581
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Provider Business Mailing Address
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Address Line | 2001 BUTTERFIELD RD STE 1600
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1211
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Country | US
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Telephone | 630-296-2222
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Fax |
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Authorized Official
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Title or Position | VP CHIEF COMPLIANCE OFFICER
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Name | WADE A MEYER
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Credential |
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Telephone | 630-296-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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