Organization
CHARLESTON PEDIATRIC REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSAY TAYLOR (CREDENTIALING SPECIALIST)
(843) 569-3033
Entity
Organization
Contact information
Practice address
2070 NORTHBROOK BLVD, SUITE B-4, NORTH CHARLESTON, SC 29406-9252
(843) 569-3033
(843) 569-6820
Mailing address
2070 NORTHBROOK BLVD, SUITE B-4, NORTH CHARLESTON, SC 29406-9252
(843) 569-3033
(843) 569-6820
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/07/2016
Last updated
04/07/2016
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