Organization
CHARLESTON CHILDREN'S THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLENE DURHAM MSR, PT (CO-OWNER/MANAGER)
(843) 569-4546
Entity
Organization
Contact information
Practice address
9225 UNIVERSITY BLVD, STE. E2C, NORTH CHARLESTON, SC 29406-9149
(843) 569-4546
(843) 569-4535
Mailing address
9225 UNIVERSITY BLVD, STE. E2C, NORTH CHARLESTON, SC 29406-9149
(843) 569-4546
(843) 569-4535
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3928
—
SC
Enumeration date
06/19/2006
Last updated
11/09/2016
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