# INTEGRATIVE THERAPY AND PERFORMANCE SPECIALISTS LLC

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

## Provider details

- **NPI number:** 1164292082
- **Authorized official:** DR. CLINTON WAYNE SERAFINO PT, DPT, FAAOMPT (OWNER)
- **Authorized official phone:** (574) 309-1427

## Contact information

- **Practice address:** 534 RIVER CROSSING DR STE 101, FORT MILL, SC 29715-7900
- **Practice address phone:** (803) 792-7367
- **Mailing address:** 268 RUNNER STONE LN, FORT MILL, SC 29715-2543
- **Mailing address phone:** (574) 309-1427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2251S0007X | Sports Physical Therapist | — | — | — |
| 2251X0800X | Orthopedic Physical Therapist | — | NULL | — |
| 2251X0800X | Orthopedic Physical Therapist | — | — | — |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225XH1200X | Hand Occupational Therapist | — | NULL | — |
| 225XH1200X | Hand Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 01/02/2024
- **Last updated:** 01/02/2024