Organization
LIVE OAKS PHYSICAL THERAPY
Active
Other names
Live Oaks Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ALLYSON GRAVES BENSCH PT (PRESIDENT)
(843) 717-2400
Entity
Organization
Contact information
Practice address
8084 E MAIN ST, SUITE A, RIDGELAND, SC 29936-8599
(843) 717-2400
(843) 717-2500
Mailing address
8084 E MAIN ST STE A, SUITE A, RIDGELAND, SC 29936-8667
(843) 717-2400
(843) 717-2500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1369
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1369
LICENSE
SC
Enumeration date
05/28/2006
Last updated
09/30/2011
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