Provider Demographics
NPI:1972203073
Name:RADIUS PHYSICAL THERAPY OF SOUTH CAROLINA
Entity Type:Organization
Organization Name:RADIUS PHYSICAL THERAPY OF SOUTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CORPORATE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KEISLING
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:842-441-0595
Mailing Address - Street 1:400 MAIN ST STE 200A4
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-4628
Mailing Address - Country:US
Mailing Address - Phone:855-583-3537
Mailing Address - Fax:855-966-4087
Practice Address - Street 1:400 MAIN ST STE 200A4
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-4628
Practice Address - Country:US
Practice Address - Phone:855-583-3537
Practice Address - Fax:855-966-4087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy