Provider Demographics
NPI:1427716281
Name:ALIVE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ALIVE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & DIRECTOR OF REHAB
Authorized Official - Prefix:DR
Authorized Official - First Name:GREIGORY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEITZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:803-728-1133
Mailing Address - Street 1:3234 FOXHALL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-3709
Mailing Address - Country:US
Mailing Address - Phone:970-672-7077
Mailing Address - Fax:
Practice Address - Street 1:4611 HARD SCRABBLE RD STE 115
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9454
Practice Address - Country:US
Practice Address - Phone:803-728-1133
Practice Address - Fax:803-728-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty