MEDICARE: CHARLESTON INJURY AND REHAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1255108478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLESTON INJURY AND REHAB LLC

Provider Business Mailing Address
First Line	:	2504 HIGHMARKET ST
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29440-2910
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5422 RIVERS AVE
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-6129
Country	:	US
Telephone Number	:	931-210-4434
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	JONATHAN ROBERTSON
Credential	:
Telephone Number	:	931-210-4434

Provider Enumeration Date	:	12/07/2023
Last Update Date	:	12/07/2023

Similar Medicare Providers

1902780448 — AKLIN CORAL LOPEZ ALVARADO
Practice Location Address:

3812 W MONTAGUE AVE APT 9209
NORTH CHARLESTON, SC
29418-6129

Practice Phone: 787-514-8105
Practice Fax:

1336873496 — VICTORIA L OLIVETO LMHC
Practice Location Address:

790 TURNPIKE ST STE 106
NORTH ANDOVER, MA
01845-6129

Practice Phone: 978-502-5847
Practice Fax:

1417938069 — MR. TZVETAN TZVETANOV M.D.
Practice Location Address:

790 TURNPIKE ST STE 300
NORTH ANDOVER, MA
01845-6129

Practice Phone: 978-687-2273
Practice Fax:

1114387578 — IRINA OSTROVSKAYA M.S., CCC-SLP
Practice Location Address:

790 TURNPIKE ST STE 105
NORTH ANDOVER, MA
01845-6129

Practice Phone: 508-478-0207
Practice Fax: 508-634-6984

1841647641 — CANDACE MACATANGAY NP
Practice Location Address:

6129 SAINT CLAIR AVE
NORTH HOLLYWOOD, CA
91606-4631

Practice Phone: 323-377-1337
Practice Fax:

1649627456 — ASHLEIGH BANKS BCBA, LBA
Practice Location Address:

6129 OLD STATE RD
NORTH BRANCH, MI
48461-8137

Practice Phone: 810-625-3250
Practice Fax:

Directions to “CHARLESTON INJURY AND REHAB LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.