Provider Demographics
NPI:1508231531
Name:PRS 6, LLC
Entity Type:Organization
Organization Name:PRS 6, LLC
Other - Org Name:PROFESSIONAL REHABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KINMARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MTC, OCS
Authorized Official - Phone:843-281-4222
Mailing Address - Street 1:PO BOX 2397
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-2397
Mailing Address - Country:US
Mailing Address - Phone:843-235-0200
Mailing Address - Fax:
Practice Address - Street 1:111 PAVILION DR
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-9396
Practice Address - Country:US
Practice Address - Phone:843-281-4222
Practice Address - Fax:843-491-4214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF404Medicare PIN