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General NPI Number Information
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NPI Number | 1992394779
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Entity Type | Organization
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Legal Business Name | HUMAN PERFORMANCE AND REHABILITATION CENTERS, LLC
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 4114 FOREST DR
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City | COLUMBIA
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State | SC
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Zip | 29204-4316
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Country | US
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Telephone | 803-939-2213
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Fax | 803-939-2214
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Provider Business Mailing Address
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Address Line | PO BOX 8068
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City | COLUMBUS
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State | GA
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Zip | 31908-8068
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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 | CEO/MEMBER
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Name | BRIAN MCCLUSKEY
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Credential |
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Telephone | 706-322-7762
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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 |
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License Number State |
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Taxonomy #2
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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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