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NPI Code Detail

MEDICARE: JOHN GRAYSON SOSSAMON

MEDICARE: JOHN GRAYSON SOSSAMON
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 Therapist13260SC

General Provider Information

NPI Number : 1790631166
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN GRAYSON SOSSAMON
Provider Business Mailing Address
First Line : 445 SAVANNAH HWY
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-7207
Country : US
Telephone Number : 843-766-2121
Fax Number :
Provider Business Practice Location Address
First Line : 445 SAVANNAH HWY
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-7207
Country : US
Telephone Number : 843-766-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ JOHN GRAYSON SOSSAMON ” Practice Location

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