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NPI Code Detail

MEDICARE: LAKEVIEW PHYSICAL THERAPY, LLC

MEDICARE: LAKEVIEW PHYSICAL THERAPY, 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
1225100000XPhysical Therapist3790SC

General Provider Information

NPI Number : 1467474551
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEVIEW PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 122 N BROOKS ST
Second Line :
City : MANNING
State : SC
Zip : 29102-3253
Country : US
Telephone Number : 803-433-9001
Fax Number : 803-433-9002
Provider Business Practice Location Address
First Line : 122 N BROOKS ST
Second Line :
City : MANNING
State : SC
Zip : 29102-3253
Country : US
Telephone Number : 803-433-9001
Fax Number : 803-433-9002
Authorized Official
Title or Position : OWNER/PHYSICAL THERAPIST
Name : STEPHANIE ANN HITE
Credential : MSPT
Telephone Number : 803-433-9001
Provider Enumeration Date : 07/24/2006
Last Update Date : 12/13/2010

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Directions to “LAKEVIEW PHYSICAL THERAPY, LLC ” Practice Location

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