Organization
PRIME PERFORMANCE REHAB, LLC
Active
Other names
Made 2 Move PT
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOT LANCE DR. (OWNER)
(803) 394-6191
Entity
Organization
Contact information
Practice address
885 ISLAND PARK DR, DANIEL ISLAND, SC 29492-7956
(843) 640-5244
Mailing address
5200 ASHCROFT AVE, NORTH CHARLESTON, SC 29405-4115
(803) 394-6191
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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