# HOLY CITY PEDIATRIC THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Holy City Pediatric Therapy, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639568231
- **Authorized official:** KELLYE TOLLEY OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (423) 388-5198

## Contact information

- **Practice address:** 142 SPORTSMAN ISLAND DR STE E, DANIEL ISLAND, SC 29492-8524
- **Practice address phone:** (423) 388-8311
- **Mailing address:** 2030 WAMBAW CREEK RD STE 200, CHARLESTON, SC 29492-8382
- **Mailing address phone:** (843) 708-9138
- **Mailing address fax:** (888) 659-8008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | — |
| 2251P0200X | Pediatric Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261Q00000X | Clinic/Center | 3907 | SC | Yes |

## Other

- **Enumeration date:** 01/20/2015
- **Last updated:** 08/24/2026