Organization Name: | CLEMSON SPORTS MEDICINE AND REHABILITATION |
NPI Number: | 1093890063 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLEEN FITZGERALD (CREDENTIALING) |
Mailing Address: | 35 Bill Fries Dr Building K Hilton Head Island |
State: | SC US |
Postal Code: | 299262730 |
Phone Number: | 8433423012 |
Fax Number: | 8433429768 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |