# MIDLANDS PHYSICAL THERAPY AND WELLNESS LLC.

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

## Provider details

- **NPI number:** 1457961963
- **Authorized official:** JEREMY WAYNE NICHOLS PT, DPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (803) 924-3581

## Contact information

- **Practice address:** 115 PETTUS LN, NEWBERRY, SC 29108-7719
- **Practice address phone:** (803) 924-3581
- **Practice address fax:** (803) 276-9495
- **Mailing address:** 115 PETTUS LN, NEWBERRY, SC 29108-7719
- **Mailing address phone:** (803) 924-3581
- **Mailing address fax:** (803) 276-9495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2020
- **Last updated:** 08/10/2020