# SUMMERVILLE PHYSICAL THERAPY & BALANCE REHABILITATION FOR ADULTS, LLC

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

## Provider details

- **NPI number:** 1194186213
- **Authorized official:** DAVID P BRUNGO P.T. (OWNER/MEMBER/PHYSICAL THERAPIST)
- **Authorized official phone:** (843) 209-6375

## Contact information

- **Practice address:** 679 ORANGEBURG ROAD, SUITE D, SUMMERVILLE, SC 29483
- **Practice address phone:** (843) 209-6375
- **Practice address fax:** (843) 225-0348
- **Mailing address:** 679 ORANGEBURG ROAD, SUITE D, SUMMERVILLE, SC 29483
- **Mailing address phone:** (843) 209-6375

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 4850 | SC | Yes |

## Other

- **Enumeration date:** 03/17/2016
- **Last updated:** 01/25/2019