Provider Demographics
NPI:1265800536
Name:PRATT PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:PRATT PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ASHTON
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:843-900-0745
Mailing Address - Street 1:3481 LADSON RD
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-4300
Mailing Address - Country:US
Mailing Address - Phone:843-900-0745
Mailing Address - Fax:866-396-4079
Practice Address - Street 1:3481 LADSON RD
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-4300
Practice Address - Country:US
Practice Address - Phone:843-900-0745
Practice Address - Fax:866-396-4079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy