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General NPI Number Information
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NPI Number | 1558414789
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Entity Type | Organization
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Legal Business Name | PEDIATRIC HOME THERAPY SERVICES
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 109 CHELLELIN DR SUITE A
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City | GAFFNEY
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State | SC
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Zip | 29341-1555
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Country | US
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Telephone | 864-978-3771
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Fax | 828-615-7252
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Provider Business Mailing Address
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Address Line | PO BOX 161555
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City | BOILING SPRINGS
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State | SC
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Zip | 29316-0026
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Country | US
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Telephone | 864-978-3771
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Fax | 828-615-7252
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN CHRISTOPHER MURRAY
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Credential | PT
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Telephone | 864-978-3771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3422
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License Number State | SC
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