# CAROLINA PEDIATRIC THERAPY INC

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

## Provider details

- **NPI number:** 1639460330
- **Authorized official:** MISS TAMMY LYNN PRIGANC MSPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (843) 455-2415

## Contact information

- **Practice address:** 538 WILD HORSE CT, MYRTLE BEACH, SC 29579-7577
- **Practice address phone:** (843) 455-2415
- **Practice address fax:** (843) 903-2742
- **Mailing address:** 538 WILD HORSE CT, MYRTLE BEACH, SC 29579-7577
- **Mailing address phone:** (843) 455-2415
- **Mailing address fax:** (843) 903-2742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 3841 | SC | Yes |
| 225200000X | Physical Therapy Assistant | 2608 | SC | — |

## Other

- **Enumeration date:** 04/28/2011
- **Last updated:** 05/01/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3841 | SOUTH CAROLINA BOARD OF PHYSICAL THERAPY EXAMINERS | SC |