Organization
OKATIE PHYSICAL THERAPY AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. ROBERT GAVIN MD (OWNER)
(843) 645-2668
Entity
Organization
Contact information
Practice address
149 RIVERWALK BLVD STE 3, RIDGELAND, SC 29936-8191
(843) 645-2668
Mailing address
15 MOSS CREEK VLG, HILTON HEAD, SC 29926-1105
(843) 681-5077
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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