# GREENVILLE PROAXIS THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ATI Physical Therapy of Greenville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669457859
- **Authorized official:** WADE A MEYER (VP CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (630) 296-2222

## Contact information

- **Practice address:** 103 N MAIN ST, STE 99, GREENVILLE, SC 29601-2796
- **Practice address phone:** (864) 528-5728
- **Practice address fax:** (864) 528-5729
- **Mailing address:** 2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
- **Mailing address phone:** (630) 296-2223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 12/09/2005
- **Last updated:** 04/15/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DD4407 | MEDICARE RAILROAD | SC |
| 05 | — | GP4143 | — | SC |