Organization
CLEMSON SPORTS MEDICINE AND REHABILITATION, INC
Active
Other names
Sports Plus
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BAXTER (CREDENTIALING)
(864) 482-0064
Entity
Organization
Contact information
Practice address
108 GATEWAY BLVD, SUITE 211-B, MOORESVILLE, NC 28117-5596
(704) 662-0386
Mailing address
PO BOX 1844, CLEMSON, SC 29633-1844
(864) 482-0064
(864) 482-0081
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7212045
—
NC
Enumeration date
09/22/2006
Last updated
03/28/2011
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