Organization
ORTHOSPORT PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF FROMDAHL MSPT (OWNER)
(843) 681-5640
Entity
Organization
Contact information
Practice address
38 SHERIDAN PARK CIR STE E, BLUFFTON, SC 29910-7023
(843) 815-5628
(843) 815-5637
Mailing address
38 SHERIDAN PARK CIR STE E, BLUFFTON, SC 29910-7023
(843) 815-5628
(843) 815-5637
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7620
MEIDICARE GROUP NUMBER
SC
Enumeration date
05/09/2008
Last updated
05/09/2008
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