Organization
HOLY CITY PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTIN TOLLEY DPT (OWNER)
(423) 388-8311
Entity
Organization
Contact information
Practice address
2103 SEWEE INDIAN CT, MT PLEASANT, SC 29466-8054
(423) 388-8311
Mailing address
2103 SEWEE INDIAN CT, MT PLEASANT, SC 29466-8054
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/07/2021
Last updated
07/23/2021
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