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Organization

GENESIS REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IAN FISH PT (PHYSICAL THERAPIST)
(803) 446-9378
Entity
Organization

Contact information

Practice address
731 POLO ROAD, WILDEWOOD DOWNS, COLUMBIA, SC 29223
(803) 446-9378
Mailing address
120 TORREYGLEN DR, LEXINGTON, SC 29072-8057
(803) 463-6465

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
799
SC

Other

Enumeration date
07/15/2010
Last updated
07/15/2010
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