Organization
CAROLINA PHYSICAL THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLLIS LESLIE LUCAS MS, PT (LEAD PHYSICAL THERAPIST)
(864) 229-2663
Entity
Organization
Contact information
Practice address
102 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2315
(864) 229-2663
(864) 227-9510
Mailing address
102 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2315
(864) 229-2663
(864) 227-9510
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
4489
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000071507
—
SC
01
—
8624
MEDICARE PTAN
SC
01
—
DN2576
RAILROAD MEDICARE GROUP PTAN
SC
Enumeration date
11/01/2006
Last updated
01/22/2010
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