Bryan Nelson Warlick, MPT

Individual provider Active NPI Physical Therapist · North Charleston, SC

NPI 1154471852 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154471852
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5107 (SC)
Practice address
2070 Northbrook Blvd Ste A10
North Charleston, SC 29406-9253
Phone
(843) 797-5167
Fax
(843) 797-5723
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5107SCMDProfessional Counselor
9919COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy Past Accepting new patients
Premier Physical Therapy Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5107 SC Yes
Physical Therapist 225100000X PT008378 GA

Addresses

Primary practice location

2070 Northbrook Blvd Ste A10
North Charleston, SC 29406-9253

Mailing address

2070 Northbrook Blvd Ste A10
North Charleston, SC 29406-9253
Phone (843) 797-5167

Other identifiers

IdentifierTypeStateIssuer
GP-3587MedicaidSC

Other providers in North Charleston, SC

All providers in North Charleston, SC · Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.