Organization
SHELLEY BIRNIE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLEY BIRNIE PT (MANAGING MEMBER)
(843) 884-1118
Entity
Organization
Contact information
Practice address
498 WANDO PARK BLVD, STE 200, MT PLEASANT, SC 29464-7902
(843) 884-1118
(843) 448-2434
Mailing address
498 WANDO PARK BLVD, STE 200, MT PLEASANT, SC 29464-7902
(843) 884-1118
(843) 448-2434
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1042
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3229888
AETNA PROVIDER NUMBER
SC
01
—
610458600
DOL NUMBER
SC
Enumeration date
03/27/2007
Last updated
01/07/2010
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