Organization
ACTIVE THERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI BUCHHOLZ (OWNER/PT)
(803) 315-1001
Entity
Organization
Contact information
Practice address
117 EAGLE POINTE DR, CHAPIN, SC 29036-9251
(803) 315-1001
Mailing address
117 EAGLE POINTE DR, CHAPIN, SC 29036-9251
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
4799
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1583
—
SC
Enumeration date
03/06/2009
Last updated
03/09/2009
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