# UPSTATE PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1568410751
- **Authorized official:** MR. DAVID LEE KEESE PT (CO-OWNER)
- **Authorized official phone:** (864) 261-3313

## Contact information

- **Practice address:** 120 MUTUAL DR, ANDERSON, SC 29621
- **Practice address phone:** (864) 261-3313
- **Practice address fax:** (864) 261-3371
- **Mailing address:** 120 MUTUAL DRIVE, ANDERSON, SC 29621
- **Mailing address phone:** (864) 261-3313
- **Mailing address fax:** (864) 261-3371

## Taxonomy

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

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 03/03/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 8340 | MEDICARE ID | SC |