Organization
UPSTATE HOME REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS CAMPASANO JR. PT, MS (CEO/OWNER)
(732) 575-0438
Entity
Organization
Contact information
Practice address
515 TORRINGTON DR, DUNCAN, SC 29334-8123
(732) 575-0438
Mailing address
515 TORRINGTON DR, DUNCAN, SC 29334-8123
(732) 575-0438
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609899970
—
NJ
Enumeration date
03/04/2022
Last updated
03/04/2022
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