Provider Demographics
NPI:1295976868
Name:BILINGUAL PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:BILINGUAL PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARONA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:843-437-4522
Mailing Address - Street 1:45 SYCAMORE AVE
Mailing Address - Street 2:APT.1728
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6710
Mailing Address - Country:US
Mailing Address - Phone:854-437-4522
Mailing Address - Fax:843-793-2400
Practice Address - Street 1:45 SYCAMORE AVE
Practice Address - Street 2:APT.1728
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6710
Practice Address - Country:US
Practice Address - Phone:854-437-4522
Practice Address - Fax:843-793-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1890Medicaid