# PHYSICAL REHABILITATION GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHYSICAL REHABILITATION GROUP, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629407606
- **Legal business name:** PHYSICAL REHABILITATION GROUP, LLC
- **Authorized official:** DAVID PEGRAM PT (OWNER)
- **Authorized official phone:** (803) 732-5887

## Contact information

- **Practice address:** 113 PROFESSIONAL PARK RD, COLUMBIA, SC 29229-7847
- **Practice address phone:** (803) 788-4705
- **Practice address fax:** (803) 788-4797
- **Mailing address:** PO BOX 3408, IRMO, SC 29063-4015
- **Mailing address phone:** (803) 732-5887
- **Mailing address fax:** (803) 732-5997

## Taxonomy

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

## Other

- **Enumeration date:** 11/11/2013
- **Last updated:** 12/07/2021