Provider Demographics
NPI:1104145697
Name:IH3 PHYSCIAL THERAPY
Entity type:Organization
Organization Name:IH3 PHYSCIAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PT
Authorized Official - Phone:843-374-0185
Mailing Address - Street 1:148 SAULS ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-2631
Mailing Address - Country:US
Mailing Address - Phone:843-374-0185
Mailing Address - Fax:843-374-0189
Practice Address - Street 1:148 SAULS ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-2631
Practice Address - Country:US
Practice Address - Phone:843-374-0185
Practice Address - Fax:843-374-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-23
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5740261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy