# PALMETTO REHABILITATION SPECIALISTS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003194978
- **Authorized official:** RICHARD BATES (CO-OWNER)
- **Authorized official phone:** (803) 802-5855

## Contact information

- **Practice address:** 105 BEN CASEY DR STE 127, FORT MILL, SC 29708-8557
- **Practice address phone:** (803) 802-5855
- **Mailing address:** 105 BEN CASEY DR, SUITE 127, FORT MILL, SC 29708-8561
- **Mailing address phone:** (803) 802-5855
- **Mailing address fax:** (803) 802-5869

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 6502 | SC | Yes |

## Other

- **Enumeration date:** 07/26/2011
- **Last updated:** 08/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4586 | — | SC |