Provider Demographics
NPI:1467082552
Name:LINNEN PEDIATRIC PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LINNEN PEDIATRIC PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LORINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINNEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:803-447-2080
Mailing Address - Street 1:165 RICE MEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9378
Mailing Address - Country:US
Mailing Address - Phone:803-447-2080
Mailing Address - Fax:
Practice Address - Street 1:165 RICE MEADOW CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9378
Practice Address - Country:US
Practice Address - Phone:803-447-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty