Individual
MR. CHRISTOPHER S MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4100 MAIN ST, SUITE 204, COLUMBIA, SC 29203-5800
(803) 735-8047
Mailing address
4100 MAIN ST, SUITE 204, COLUMBIA, SC 29203-5800
(803) 735-8047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2582
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
571096863
TAX ID
SC
05
—
TH0474
—
SC
Enumeration date
03/09/2007
Last updated
07/09/2007
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