# DRAYER PHYSICAL THERAPY - SOUTH CAROLINA, LLC

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

## Provider details

- **NPI number:** 1275198152
- **Authorized official:** KEVIN JOHANNESON (VICE PRESIDENT OF REVENUE CYCLE)
- **Authorized official phone:** (423) 238-2313

## Contact information

- **Practice address:** 135 BLYTHEWOOD RD STE J, BLYTHEWOOD, SC 29016-8426
- **Practice address phone:** (803) 851-1037
- **Practice address fax:** (803) 851-1820
- **Mailing address:** 135 BLYTHEWOOD RD STE J, BLYTHEWOOD, SC 29016-8426
- **Mailing address phone:** (803) 851-1037
- **Mailing address fax:** (803) 851-1820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 05/06/2019
- **Last updated:** 05/20/2019