Organization
CORNELL THERAPY ASSOCIATE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD HUSSEY CORNELL OTR (OWNER)
(803) 968-4723
Entity
Organization
Contact information
Practice address
2570 CARRIAGE DR, SUMTER, SC 29154-7111
(803) 968-4723
Mailing address
2570 CARRIAGE DR, SUMTER, SC 29154-7111
(803) 968-4723
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2216
SC
Other
Enumeration date
03/20/2007
Last updated
06/25/2012
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