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General NPI Number Information
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NPI Number | 1881663300
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Entity Type | Organization
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Legal Business Name | PALMETTO REHAB OF CHARLESTON LLC
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 90 SPRINGVIEW LN
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8153
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Country | US
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Telephone | 843-875-2959
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Fax | 843-875-2836
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Provider Business Mailing Address
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Address Line | PO BOX 51989
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City | SUMMERVILLE
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State | SC
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Zip | 29485-1989
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Country | US
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Telephone | 843-875-2959
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Fax | 843-875-2836
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Authorized Official
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Title or Position | OWNER
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Name | CLYDE HIERS
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Credential |
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Telephone | 843-875-2959
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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 | SC
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