Organization
CHARLESTON PEDIATRIC REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COYLE (OWNER)
(843) 769-0663
Entity
Organization
Contact information
Practice address
1407 ASHLEY RIVER RD, CHARLESTON, SC 29407-5305
(843) 364-5437
Mailing address
2070 NORTHBROOK BLVD STE B4, NORTH CHARLESTON, SC 29406-9254
(843) 364-5437
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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