Provider Demographics
NPI:1952724999
Name:CENTER FOR HEALING AND RESTORATIVE THERAPY
Entity type:Organization
Organization Name:CENTER FOR HEALING AND RESTORATIVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:843-368-1254
Mailing Address - Street 1:32 PALMETTO BAY RD STE A6
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-7303
Mailing Address - Country:US
Mailing Address - Phone:843-368-1254
Mailing Address - Fax:
Practice Address - Street 1:32 PALMETTO BAY RD STE A6
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-7303
Practice Address - Country:US
Practice Address - Phone:843-368-1254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6276261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy