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General NPI Number Information
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NPI Number | 1770465155
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Entity Type | Organization
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Legal Business Name | LITTLE TRACKS PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1110 WOODSIDE DR
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City | CHARLESTON
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State | SC
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Zip | 29412-9362
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Country | US
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Telephone | 314-330-3658
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 CAMP RD # 87
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City | CHARLESTON
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State | SC
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Zip | 29412-4012
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Country | US
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Telephone | 314-330-3658
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | JULIA BRENNAN
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Credential | PT, DPT
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Telephone | 314-330-3658
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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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