Organization
PHYSICAL RESTORATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODERICK LEIGHTON PEDDY D.C. (OWNER)
(803) 327-8300
Entity
Organization
Contact information
Practice address
452 LAKESHORE PKWY, SUITE 230, ROCK HILL, SC 29730-4291
(803) 327-8300
Mailing address
452 LAKESHORE PKWY, SUITE 230, ROCK HILL, SC 29730-4291
(803) 327-8300
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3377
SC
Other
Enumeration date
08/29/2008
Last updated
08/29/2008
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