# PRIME PERFORMANCE REHAB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Made 2 Move PT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992444319
- **Authorized official:** ELLIOT LANCE DR. (OWNER)
- **Authorized official phone:** (803) 394-6191

## Contact information

- **Practice address:** 885 ISLAND PARK DR, DANIEL ISLAND, SC 29492-7956
- **Practice address phone:** (843) 640-5244
- **Mailing address:** 5200 ASHCROFT AVE, NORTH CHARLESTON, SC 29405-4115
- **Mailing address phone:** (803) 394-6191

## Taxonomy

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

## Other

- **Enumeration date:** 06/02/2022
- **Last updated:** 06/02/2022