Organization
PRO FORM THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLEN MICHAEL BROWN MPT, MBA (PHYSICAL THERAPIST)
(843) 861-2127
Entity
Organization
Contact information
Practice address
1109 S 5TH ST, HARTSVILLE, SC 29550-5797
(843) 861-2127
Mailing address
632 COLONY RD, HARTSVILLE, SC 29550-7976
(843) 861-2127
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5186
SC
Other
Enumeration date
01/07/2007
Last updated
08/22/2020
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