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Organization
PRO FORM THERAPY, LLC
Active
Organization
PRO FORM THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLEN MICHAEL BROWN MPT, MBA (PHYSICAL THERAPIST)
(843) 861-2127
Entity
Organization
Contact information
Practice address
1109 S 5TH ST, HARTSVILLE, SC 29550-5797
(843) 861-2127
Mailing address
632 COLONY RD, HARTSVILLE, SC 29550-7976
(843) 861-2127
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5186
SC
Other
Enumeration date
01/07/2007
Last updated
08/22/2020
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