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General NPI Number Information
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NPI Number | 1679377428
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Entity Type | Organization
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Legal Business Name | FLORENCE MYOFASCIAL RELEASE AND PT LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1210 S CASHUA DR STE 8/9
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City | FLORENCE
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State | SC
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Zip | 29501-5325
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Country | US
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Telephone | 843-229-3061
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Fax |
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Provider Business Mailing Address
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Address Line | 3810 MASTERS CIR
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City | FLORENCE
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State | SC
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Zip | 29501-8514
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Country | US
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Telephone | 843-229-3061
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Fax |
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Authorized Official
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Title or Position | OWNER AND PROVIDER
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Name | SANDRA DE CASSIA MARTINS-SKOLNY
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Credential |
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Telephone | 843-229-3061
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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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