# SC FYZICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861964710
- **Authorized official:** HEATHER BASHAM (PROVIDER LIAISON)
- **Authorized official phone:** (803) 408-3277

## Contact information

- **Practice address:** 110 HIGHLAND CENTER DR, COLUMBIA, SC 29203-9247
- **Practice address phone:** (803) 408-3277
- **Practice address fax:** (803) 408-8698
- **Mailing address:** 15 EXCHANGE DR, LUGOFF, SC 29078-9198
- **Mailing address phone:** (803) 408-3277
- **Mailing address fax:** (803) 408-8698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/17/2018
- **Last updated:** 12/18/2018