Provider Demographics
NPI:1972560670
Name:PALMETTO THERAPY SERVICES
Entity Type:Organization
Organization Name:PALMETTO THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:843-842-3222
Mailing Address - Street 1:811 WILLIAM HILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-3442
Mailing Address - Country:US
Mailing Address - Phone:843-842-3222
Mailing Address - Fax:843-842-3202
Practice Address - Street 1:811 WILLIAM HILTON PKWY
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-3442
Practice Address - Country:US
Practice Address - Phone:843-842-3222
Practice Address - Fax:843-842-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDC2026OtherMEDICARE RAILROAD PROVIDER NUMBER
SCQ32776-7643Medicare ID - Type UnspecifiedPHYSICAL THERAPY GROUP