Organization
IMPACT THERAPY, LLC
Active
Other names
Therapy 4 Seniors, LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
JERRERY E. KINARD (PRESIDENT)
(843) 216-6800
Entity
Organization
Contact information
Practice address
3409 SALTERBECK CT, MT PLEASANT, SC 29466-7117
(843) 216-6800
Mailing address
3409 SALTERBECK CT, MT PLEASANT, SC 29466-7117
(843) 216-6800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5481
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8952
MEDICARE PTAN
SC
Enumeration date
01/14/2008
Last updated
07/09/2014
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