| Charles Francis Jacob, DPT | |
|
2650 Saint Matthews Rd, Orangeburg, SC 29118-1344 | |
| (803) 536-5509 | |
| Not Available |
| Full Name | Charles Francis Jacob |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 2650 Saint Matthews Rd, Orangeburg, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073331807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 13035 (South Carolina) | Primary |
| 225100000X | Physical Therapist | J1-0014962 (Delaware) | Secondary |
| Provider Name | Ati Holdings, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1396781050 PECOS PAC ID: 9537112719 Enrollment ID: O20061101000380 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Francis Jacob, DPT 2001 Butterfield Rd Ste 1600, Downers Grove, IL 60515-1211 Ph: (866) 370-8206 | Charles Francis Jacob, DPT 2650 Saint Matthews Rd, Orangeburg, SC 29118-1344 Ph: (803) 536-5509 |
Shanelle Natalie Balfour, P. T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1620 Broughton St, Orangeburg, SC 29115 Phone: 803-534-4050 Fax: 803-534-0408 | |
Neil Gallagher, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2650 Saint Matthews Rd, Orangeburg, SC 29118 Phone: 803-536-5509 | |
Emily Lauren Walker, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2650 Saint Matthews Rd, Orangeburg, SC 29118 Phone: 803-536-5509 Fax: 803-536-4104 | |
Mr. John Christopher Lukowski, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3000 Saint Matthews Rd, Orangeburg, SC 29118 Phone: 803-395-4380 Fax: 803-395-4376 | |
Ellen Fay Patrick, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 119 Office Park Dr, Orangeburg, SC 29118 Phone: 803-536-5509 Fax: 843-536-4104 | |
Ryan Hagerty, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1304 Glen Gloria St, Orangeburg, SC 29118 Phone: 423-682-8840 |