MEDICARE: ADVANTAGE PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	225X00000X	Occupational Therapist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1427575091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	537 LONG POINT RD STE 106
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-8279
Country	:	US
Telephone Number	:	843-718-2683
Fax Number	:	843-388-7149

Provider Business Practice Location Address
First Line	:	537 LONG POINT RD STE 106
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-8279
Country	:	US
Telephone Number	:	843-718-2683
Fax Number	:	803-573-1050

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN CANCIENNE
Credential	:
Telephone Number	:	843-718-2683

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	01/28/2026

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Directions to “ADVANTAGE PHYSICAL THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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