Palmetto Restorative Therapy
Organization Active NPI Physical Therapist · Huger, SC
NPI 1972364016 · NPPES record last updated Jan 17, 2024
Key facts
- NPI
- 1972364016
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- PALMETTO RESTORATIVE THERAPY
- Practice address
- 247 Camber Rd
Huger, SC 29450-8525 - Phone
- (843) 345-2814
- NPI assigned
- Jan 17, 2024
- Organization subpart
- No
Authorized official
- Name
- Andrew Tyler
- Title
- Owner
- Phone
- (843) 345-2814
Practitioners 2
-
Andrew Fred Tyler, PTA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240510002347 | SC | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2567803380 |
Receives reassigned benefits from 1 practitioner Practice locations: Huger, SC |
National Provider Directory
Locations
454 Jessen Ln
Charleston, SC 29492
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Physical Therapy Assistant |
225200000X |
Addresses
Primary practice location
247 Camber Rd
Huger, SC 29450-8525
Mailing address
247 Camber Rd
Huger, SC 29450-8525
Phone (843) 345-2814
Other providers in Huger, SC
- Angela Rose Engle
- Margaretta C. Grimm
- Kristi Ann Jones
- Rodney Darrell Lockwood
- Eunice Price Moore
- Jacqueline Pryor
- Megan Kathleen Shanahan
- Andrew Fred Tyler
- Gretchen Tyler
All providers in Huger, SC · Physical Therapist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.