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General NPI Number Information
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NPI Number | 1992028104
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Entity Type | Organization
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Legal Business Name | SERENITY REHAB & WELLNESS CENTER
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 3795 E NORTH ST SUITE 14
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City | GREENVILLE
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State | SC
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Zip | 29615-6200
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Country | US
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Telephone | 864-292-0011
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Fax | 864-292-0303
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Provider Business Mailing Address
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Address Line | 3795 E NORTH ST SUITE 14
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City | GREENVILLE
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State | SC
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Zip | 29615-6200
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Country | US
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Telephone | 864-292-0011
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Fax | 264-292-0303
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Authorized Official
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Title or Position | PHYSICAL THERAPIST AND OWNER
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Name | MS. TRVERA L WILLIAMS
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Credential |
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Telephone | 864-292-0011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4253
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License Number State | SC
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