Individual
MARK ALLEN RENTFROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
325 FOLLY RD STE 107, CHARLESTON, SC 29412-2507
(843) 762-0147
(843) 762-0421
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
SC
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11116
STATE LICENSE
SC
Enumeration date
02/15/2022
Last updated
04/18/2024
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