# ORTHOSPORT PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1891962700
- **Authorized official:** JEFF FROMDAHL MSPT (OWNER)
- **Authorized official phone:** (843) 681-5640

## Contact information

- **Practice address:** 38 SHERIDAN PARK CIR STE E, BLUFFTON, SC 29910-7023
- **Practice address phone:** (843) 815-5628
- **Practice address fax:** (843) 815-5637
- **Mailing address:** 38 SHERIDAN PARK CIR STE E, BLUFFTON, SC 29910-7023
- **Mailing address phone:** (843) 815-5628
- **Mailing address fax:** (843) 815-5637

## Taxonomy

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

## Other

- **Enumeration date:** 05/09/2008
- **Last updated:** 05/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 7620 | MEIDICARE GROUP NUMBER | SC |