| Centrum Therapy Services | |
|
104 Mallory Dr, Goose Creek, SC 29445-6406 | |
| (864) 275-0740 | |
| (843) 808-6986 |
| Full Name | Centrum Therapy Services |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 104 Mallory Dr, Goose Creek, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396455515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| Provider Name | Nicole Christine Koechell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912461922 PECOS PAC ID: 4587903539 Enrollment ID: I20190308001717 |
| Provider Name | Kirby Broome |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558928523 PECOS PAC ID: 9638408651 Enrollment ID: I20190916003545 |
| Provider Name | Nathaniel Kevin Prater |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013575968 PECOS PAC ID: 0941538573 Enrollment ID: I20220426003095 |
| Mailing Address | Practice Location Address |
|---|---|
| Centrum Therapy Services Po Box 1119, Goose Creek, SC 29445-1119 Ph: (864) 993-6304 | Centrum Therapy Services 104 Mallory Dr, Goose Creek, SC 29445-6406 Ph: (864) 275-0740 |
Nathaniel Kevin Prater, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 104 Mallory Dr, Goose Creek, SC 29445 Phone: 864-993-6304 Fax: 843-808-6986 | |
Jeffrey Thomas Noelcke, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 214 Saint James Ave, Goose Creek, SC 29445 Phone: 843-793-4466 | |
Joseph Styron, Physical Therapist Medicare: Medicare Enrolled Practice Location: 514 Saint James Ave Unit G, Goose Creek, SC 29445 Phone: 843-642-8660 | |
Jessica A Lyons, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 215 Blossom St, Goose Creek, SC 29445 Phone: 843-469-1400 | |
Zachary Harding Thomas, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7 S Alliance Dr Ste 102a, Goose Creek, SC 29445 Phone: 803-569-2303 | |
Sarah Enzaldo Smith, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 214 Saint James Ave Ste 140b, Goose Creek, SC 29445 Phone: 843-793-4466 Fax: 843-794-3786 | |
John Andrew Inman, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 588 Old Mount Holly Rd, Goose Creek, SC 29445 Phone: 843-376-5595 |