Organization
HOLY CITY PEDIATRIC THERAPY LLC
Active
Other names
Holy City Pediatric Therapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KELLYE TOLLEY OTR/L (OCCUPATIONAL THERAPIST)
(423) 388-5198
Entity
Organization
Contact information
Practice address
142 SPORTSMAN ISLAND DR STE E, DANIEL ISLAND, SC 29492-8524
(423) 388-8311
Mailing address
142 SPORTSMAN ISLAND DR STE E, CHARLESTON, SC 29492-8524
(843) 708-9138
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
3907
SC
Other
Enumeration date
01/20/2015
Last updated
02/22/2023
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