Organization
CLEMSON SPORTS MEDICINE AND REHABILITATION, INC
Active
Parent organization
CLEMSON SPORTS MEDICINE AND REHABILITATION, INC
Other names
Goose Creek Physical Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLEMSON SPORTS MEDICINE AND REHABILITATION, INC
Authorized official
JENNIFER MCQUILLEN (CREDENTIALING)
(864) 482-0064
Entity
Organization
Contact information
Practice address
217A SAINT JAMES AVE, GOOSE CREEK, SC 29445-2990
(843) 531-5495
(843) 277-6232
Mailing address
PO BOX 1844, CLEMSON, SC 29633-1844
(864) 482-0064
(864) 482-0081
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
—
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
05/21/2013
Last updated
03/09/2016
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