| Organization Name: | YOUR LIFE WELLNESS AND PHYSICAL THERAPY |
| NPI Number: | 1184973489 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEE ANN GASTON (OWNER/PHYSICAL THERAPIST) |
| Mailing Address: | 7580 Charlotte Hwy Suite 500 Indian Land |
| State: | SC US |
| Postal Code: | 297077801 |
| Phone Number: | 8035485662 |
| Fax Number: | 8035485635 |
| NPI Enumeration Date: | 08/31/2012 |
| NPI Last Update Date: | 08/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 2342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |