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Organization
ACKER PHYSICAL THERAPY
Active
Organization
ACKER PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON DANESE LOTT (BILLING/CREDENTIALING MANAGER)
(803) 667-1819
Entity
Organization
Contact information
Practice address
144 LEISURE LN STE 100, COLUMBIA, SC 29210-4156
(803) 331-3682
(803) 791-3862
Mailing address
144 LEISURE LN STE 100, COLUMBIA, SC 29210-4156
(803) 888-6125
(803) 888-6085
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1580
SC
261QP2000X
Physical Therapy Clinic/Center
5266
SC
Other
Enumeration date
11/15/2016
Last updated
07/25/2019
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