# IMPACT THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Therapy 4 Seniors, LLC.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336325984
- **Authorized official:** JERRERY E. KINARD (PRESIDENT)
- **Authorized official phone:** (843) 216-6800

## Contact information

- **Practice address:** 3409 SALTERBECK CT, MT PLEASANT, SC 29466-7117
- **Practice address phone:** (843) 216-6800
- **Mailing address:** 3409 SALTERBECK CT, MT PLEASANT, SC 29466-7117
- **Mailing address phone:** (843) 216-6800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 5481 | SC | Yes |

## Other

- **Enumeration date:** 01/14/2008
- **Last updated:** 07/09/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 8952 | MEDICARE PTAN | SC |