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General NPI Number Information
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NPI Number | 1912852526
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Entity Type | Organization
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Legal Business Name | REBEL PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 5 SYCAMORE AVE MOBILE CLINIC - NO SERVICES RENDERED AT THIS ADDRESS
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City | CHARLESTON
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State | SC
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Zip | 29407
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Country | US
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Telephone | 951-813-6148
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Fax |
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Provider Business Mailing Address
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Address Line | 5 SYCAMORE AVE
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City | CHARLESTON
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State | SC
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Zip | 29407-6705
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Country | US
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Telephone | 951-813-6148
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. HOLLY KNAPP
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Credential | PT, DPT
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Telephone | 951-813-6148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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