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Organization
IN HOME REHAB OF SOUTH CAROLINA LLC
Active
Organization
IN HOME REHAB OF SOUTH CAROLINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG PETERS (OWNER)
(803) 407-3869
Entity
Organization
Contact information
Practice address
47 HAVEN RIDGE CT, COLUMBIA, SC 29212-2881
(803) 407-3869
Mailing address
47 HAVEN RIDGE CT, COLUMBIA, SC 29212-2881
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4267
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250518500
BLUE CROSS BLUE SHIELD
SC
Enumeration date
07/30/2006
Last updated
05/26/2015
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