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Organization

SUPERKIDZ PEDIATRIC THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY B CALDWELL (CEO)
(803) 509-3459
Entity
Organization

Contact information

Practice address
1700 QUAIL LAKE DR, WEST COLUMBIA, SC 29169-3746
(803) 509-3459
Mailing address
PO BOX 2791, COLUMBIA, SC 29202-2791
(803) 509-3459

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
06/08/2015
Last updated
06/08/2015
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