Organization
TIDAL CREEK PHYSICAL THERAPY, LLC
Active
Parent organization
TIDAL CREEK PHYSICAL, LLC
Other names
Tidal Creek Physical Beaufort
Organization subpart
Yes
Provider details
NPI number
Legal business name
TIDAL CREEK PHYSICAL, LLC
Authorized official
JEREMY CANNON PTA (PTA)
(843) 379-3991
Entity
Organization
Contact information
Practice address
95 SEA ISLAND PKWY STE 103, BEAUFORT, SC 29907-1499
(843) 379-3991
Mailing address
11 ROBERT SMALLS PKWY, BEAUFORT, SC 29906-4202
(843) 379-3991
(843) 582-0283
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
01/06/2025
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