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Organization

ORTHOSPORT PHYSICAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFF FROMDAHL MSPT (OWNER)
(843) 681-5640
Entity
Organization

Contact information

Practice address
95 MATHEWS DR STE D5, HILTON HEAD, SC 29926-3768
(843) 681-5640
(843) 681-5631
Mailing address
95 MATHEWS DR STE D5, HILTON HEAD, SC 29926-3768
(843) 681-5640
(843) 681-5631

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7620
MEDICARE GROUP NUMBER
SC
Enumeration date
05/09/2008
Last updated
05/09/2008
About Stedi
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  • EDI platform