Provider Demographics
NPI:1598852261
Name:COLUMBIA REHABILITATION CLINIC, INC.
Entity type:Organization
Organization Name:COLUMBIA REHABILITATION CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:FILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:803-799-7007
Mailing Address - Street 1:7182 WOODROW STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2873
Mailing Address - Country:US
Mailing Address - Phone:803-749-0808
Mailing Address - Fax:803-749-0308
Practice Address - Street 1:7182 WOODROW ST STE 102
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2958
Practice Address - Country:US
Practice Address - Phone:803-749-0808
Practice Address - Fax:803-749-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty