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Organization

CAROLINA PEDIATRIC THERAPY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS TAMMY LYNN PRIGANC MSPT (PHYSICAL THERAPIST)
(843) 455-2415
Entity
Organization

Contact information

Practice address
538 WILD HORSE CT, MYRTLE BEACH, SC 29579-7577
(843) 455-2415
(843) 903-2742
Mailing address
538 WILD HORSE CT, MYRTLE BEACH, SC 29579-7577
(843) 455-2415
(843) 903-2742

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3841
SC
225200000X
Physical Therapy Assistant
2608
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3841
SOUTH CAROLINA BOARD OF PHYSICAL THERAPY EXAMINERS
SC
Enumeration date
04/28/2011
Last updated
05/01/2011
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