Provider Demographics
NPI:1790480606
Name:PRECISION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:PRECISION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:MANNING
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:803-983-2039
Mailing Address - Street 1:1165 BROAD STREET, PMB 352
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150
Mailing Address - Country:US
Mailing Address - Phone:803-983-2039
Mailing Address - Fax:
Practice Address - Street 1:540 BULTMAN DR STE 3
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2592
Practice Address - Country:US
Practice Address - Phone:803-983-2039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty