Organization
LOWCOUNTRY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSI FUSTOS (FOUNDER)
(843) 815-6999
Entity
Organization
Contact information
Practice address
29 PLANTATION PARK DR STE 403, BLUFFTON, SC 29910-9006
(843) 815-6999
(843) 815-6668
Mailing address
PO BOX 2421, BLUFFTON, SC 29910-2421
(843) 815-6999
(843) 815-6998
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3804
SC
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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