Provider Demographics
NPI:1588047732
Name:PILGRIM, JOSEPH A (DPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:PILGRIM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 BRUSHY CREEK RD
Practice Address - Street 2:SUITE A
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1120
Practice Address - Country:US
Practice Address - Phone:864-343-2650
Practice Address - Fax:864-343-2680
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist