Provider Demographics
NPI:1356773873
Name:DRAYER PHYSICAL THERAPY-SOUTH CAROLINA, LLC
Entity type:Organization
Organization Name:DRAYER PHYSICAL THERAPY-SOUTH CAROLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAND & CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:10 WILLIAM POPE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7549
Mailing Address - Country:US
Mailing Address - Phone:843-705-9440
Mailing Address - Fax:843-705-9445
Practice Address - Street 1:10 WILLIAM POPE DR STE 5
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-7550
Practice Address - Country:US
Practice Address - Phone:843-705-9440
Practice Address - Fax:843-705-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty