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General NPI Number Information
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NPI Number | 1962045500
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Entity Type | Organization
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Legal Business Name | BRIGHT PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 4010 E NORTH ST STE 4
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City | GREENVILLE
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State | SC
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Zip | 29615-6208
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Country | US
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Telephone | 864-201-6029
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Fax |
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Provider Business Mailing Address
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Address Line | 121 BENDINGWOOD CIR
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City | TAYLORS
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State | SC
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Zip | 29687-4504
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ORGANIZER
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Name | KIM BRIGHT
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Credential | PT
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Telephone | 864-201-6029
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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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