Provider Demographics
NPI:1659025377
Name:WISE LITTLE MOVERS - PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:WISE LITTLE MOVERS - PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAVANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:717-919-0312
Mailing Address - Street 1:825 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5853
Mailing Address - Country:US
Mailing Address - Phone:575-208-6314
Mailing Address - Fax:
Practice Address - Street 1:825 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5853
Practice Address - Country:US
Practice Address - Phone:575-208-6314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty