Organization · NPI-2
Charleston Physical Medicine LLC
Nurse Practitioner · Charleston, SC
NPI number1275366551
StatusActive
Last updated in NPPESAug 22, 2024
Details
- NPI
- 1275366551
- Entity type
- Organization (NPI-2)
- Legal business name
- Charleston Physical Medicine LLC
- Organization subpart
- No
- Enumeration date
- Aug 22, 2024
- Certification date
- Aug 22, 2024
- Last updated
- Aug 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
| 111N00000X | Chiropractor | – | – | |
| 261Q00000X | Clinic/Center | – | – |
Other names
- Charleston Neck And Back Center (Doing Business As)
Practice location
1835 Savage RdCharleston, SC 29407-4726
Phone 843-763-2225
Mailing address
1835 Savage RdCharleston, SC 29407-4726
Phone 843-763-2225
Authorized official
Heath Hishon
Clinic Director / Owner
8437632225
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