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Organization

DRE HOLDING CO LLC

Active
Other names
PhysioFunction PT & Performance
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE RICHARD DAUGHERTY DPT (OWNER)
(803) 816-0136
Entity
Organization

Contact information

Practice address
857 MALLARD LAKES DR, LEXINGTON, SC 29072-7572
(803) 816-0136
Mailing address
100 OLD CHEROKEE RD STE F260, LEXINGTON, SC 29072-9316
(803) 816-0136

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Enumeration date
01/10/2024
Last updated
02/21/2024
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