Organization
LOWCOUNTRY PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE WILKINSON (MEMBER)
(704) 301-4733
Entity
Organization
Contact information
Practice address
3019 SAINTSBURY COVE DR, CHARLESTON, SC 29414-8001
(704) 301-4733
Mailing address
3019 SAINTSBURY COVE DR, CHARLESTON, SC 29414-8001
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6203
SC
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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