# BLUE RIDGE PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blue Ridge Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578347712
- **Authorized official:** CAROLYN GILLIAM DPT (OWNER, PHYSICAL THERAPIST)
- **Authorized official phone:** (843) 532-1339

## Contact information

- **Practice address:** 111 MOCCASIN RUN, SUNSET, SC 29685-2507
- **Practice address phone:** (843) 532-1339
- **Mailing address:** 111 MOCCASIN RUN, SUNSET, SC 29685-2507
- **Mailing address phone:** (843) 532-1339

## Taxonomy

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

## Other

- **Enumeration date:** 08/21/2023
- **Last updated:** 09/06/2023