Organization
GROUPHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE RENEE HAZAN (OWNER, FOUNDER, PHYSICAL THERAPIST)
(864) 525-2654
Entity
Organization
Contact information
Practice address
30 HOWARD CREEK DR, FOUNTAIN INN, SC 29644-1318
(864) 525-2654
Mailing address
205 SHADOWBROOKE CT, SIMPSONVILLE, SC 29681-5184
(864) 525-2654
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
3027
SC
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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