Organization
PALMETTO PRIMARY CARE PHYSICIANS, LLC
Active
Other names
Palmetto Advanced Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY CUNNINGHAM CEO (DIRECTOR)
(843) 695-6071
Entity
Organization
Contact information
Practice address
5500 FRONT ST STE 203, SUMMERVILLE, SC 29486-8137
(843) 879-4060
(854) 220-0120
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5881
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG1153
—
SC
Enumeration date
10/30/2019
Last updated
10/11/2022
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