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Kelly Mack, PT
Pediatric Physical Therapist in Irmo, South Carolina
NPI 1215184056

Kelly Mack is a Pediatric Physical Therapist based in Irmo, SC and is specialized in Pediatrics. Kelly Mack practices in Irmo, SC and has the professional credentials of PT. The NPI Number for Kelly Mack is 1215184056 and holds a License No. 2278 (South Carolina).

The current practice location address for Kelly Mack is 107 Holly Creek Dr, Irmo, SC and can be reached out via phone at 803-749-1625.

Location: 107 Holly Creek Dr, Irmo, SC, 29063-8918
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215184056
Provider Name
Kelly Mack
Credential
PT
Provider Entity Type
Individual
Gender
Female
Address
107 Holly Creek Dr, Irmo, SC, 29063-8918
Phone Number
803-749-1625
Fax Number
Provider Enumeration Date
08/23/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
THO443 05 SC
institution
Provider Business Practice Location Address Details
Address
107 Holly Creek Dr
City
Irmo
State
South Carolina
Zip
29063-8918
Phone Number
803-749-1625
Fax Number
person
Provider Business Mailing Address Details
Address
107 Holly Creek Dr
City
Irmo
State
South Carolina
Zip
29063-8918
Phone Number
803-749-1625
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Physical Therapist
Speciality
Pediatrics
Taxonomy
2251P0200X
License No.
2278 (South Carolina)
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.
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