MEDICARE: DAYSPRING THERAPEUTIC SERVICES, P.C.

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1396932950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYSPRING THERAPEUTIC SERVICES, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 13885
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29422-3885
Country	:	US
Telephone Number	:	843-817-6145
Fax Number	:

Provider Business Practice Location Address
First Line	:	1645 RAOUL WALLENBERG BLVD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-3507
Country	:	US
Telephone Number	:	843-817-6145
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LEIGH BETH WOODMAN
Credential	:	PT
Telephone Number	:	843-817-6145

Provider Enumeration Date	:	09/27/2007
Last Update Date	:	09/27/2007

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