Provider Demographics
NPI:1518162767
Name:FLORENCE PHYSICAL THERAPY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FLORENCE PHYSICAL THERAPY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:(OWNER)PRESIDENT,VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:843-679-0930
Mailing Address - Street 1:2608 W PALMETTO ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5928
Mailing Address - Country:US
Mailing Address - Phone:843-679-0930
Mailing Address - Fax:843-679-0600
Practice Address - Street 1:2608 W PALMETTO ST
Practice Address - Street 2:SUITE A
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5928
Practice Address - Country:US
Practice Address - Phone:843-679-0930
Practice Address - Fax:843-679-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1098225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty