# JLC REHAB, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** INDIGO PHYSICAL THERAPY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801865399
- **Authorized official:** DR. EDGAR J. KLIXBULL DPT (PARTNER)
- **Authorized official phone:** (843) 357-4039

## Contact information

- **Practice address:** 11931 PLAZA DR, MURRELLS INLET, SC 29576-9356
- **Practice address phone:** (843) 357-4039
- **Practice address fax:** (843) 357-4227
- **Mailing address:** 11931 PLAZA DR, PO BOX 1795, MURRELLS INLET, SC 29576-9356
- **Mailing address phone:** (843) 357-4039
- **Mailing address fax:** (843) 357-4227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 5347 | SC | Yes |

## Other

- **Enumeration date:** 03/16/2006
- **Last updated:** 05/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP2523 | — | SC |