Provider Demographics
NPI:1437981503
Name:FOUNDATION PHYSIOTHERAPY LLC
Entity type:Organization
Organization Name:FOUNDATION PHYSIOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-310-1544
Mailing Address - Street 1:1127 SALTWATER CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-7959
Mailing Address - Country:US
Mailing Address - Phone:843-310-1544
Mailing Address - Fax:
Practice Address - Street 1:1127 SALTWATER CIR
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-7959
Practice Address - Country:US
Practice Address - Phone:843-310-1544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy