| Organization Name: | LOWCOUNTRY PEDIATRIC THERAPY LLC |
| NPI Number: | 1003295908 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACQUELINE WILKINSON (MEMBER) |
| Mailing Address: | 3019 Saintsbury Cove Dr Charleston |
| State: | SC US |
| Postal Code: | 294148001 |
| Phone Number: | 7043014733 |
| Fax Number: | |
| NPI Enumeration Date: | 05/26/2015 |
| NPI Last Update Date: | 05/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 6203 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |