Provider Demographics
NPI:1013376821
Name:DRAYER PHYSICAL THERAPY-SOUTH CAROLINA, LLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY-SOUTH CAROLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:10 WILLIAM POPE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7549
Mailing Address - Country:US
Mailing Address - Phone:843-705-9440
Mailing Address - Fax:843-705-9445
Practice Address - Street 1:130 AMICKS FERRY RD
Practice Address - Street 2:SUITE G
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-9400
Practice Address - Country:US
Practice Address - Phone:803-932-2176
Practice Address - Fax:803-932-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty