| Jag28 Llc | |
|
420 Herlong Ave S Ste 104, Rock Hill, SC 29732-1091 | |
| (623) 670-0399 | |
| Not Available |
| Full Name | Jag28 Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 420 Herlong Ave S Ste 104, Rock Hill, 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 |
|---|---|---|---|
| 1801655832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Ian Scollins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396177234 PECOS PAC ID: 3072886969 Enrollment ID: I20240912003796 |
| Provider Name | Sarah Cooley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023101276 PECOS PAC ID: 7214015882 Enrollment ID: I20241010004249 |
| Mailing Address | Practice Location Address |
|---|---|
| Jag28 Llc 4425 Sharon Rd Unit S802, Charlotte, NC 28211-3691 Ph: (162) 367-0039 | Jag28 Llc 420 Herlong Ave S Ste 104, Rock Hill, SC 29732-1091 Ph: (623) 670-0399 |
Tammy C Gantzer, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 134 Professional Park Drive, Rock Hill, SC 29732 Phone: 803-329-4685 Fax: 803-329-4683 | |
Zachary Titus Berg, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1915 Ebenezer Rd, Rock Hill, SC 29732 Phone: 803-366-8155 | |
Michael Arcidiacono, PT, DPT, ATC Physical Therapist Medicare: Medicare Enrolled Practice Location: 154 Amendment Ave, Rock Hill, SC 29732 Phone: 803-366-9990 Fax: 803-366-9960 | |
Amanda Borth, DPT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 1525 Celanese Rd Ste 113, Rock Hill, SC 29732 Phone: 803-366-8243 Fax: 803-366-8245 | |
Kathy Z Dorton, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2156 Olde Creek Rd, Rock Hill, SC 29732 Phone: 803-324-5846 Fax: 803-324-5846 | |
Mrs. Carole Barber Tiedeman, PT PHYSICAL THERAPIS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1169 Ebenezer Rd Ste C, Rock Hill, SC 29732 Phone: 803-324-5370 Fax: 803-324-7650 |