Individual ProviderNathaniel Kevin PraterPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address104 Mallory Dr, Goose Creek, SC 29445-6406(843) 996-1471PECOS EnrollmentBased on the most recent information from CMS, provider Nathaniel Kevin Prater does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1013575968Provider TypeIndividualFull NamePrater, Nathaniel KevinCredentialPT, DPTGenderMaleSole ProprietorNoEnumeration Date6/4/2019Last Updated2/20/2025Contact InformationPractice LocationPractice Address104 Mallory Dr, Goose Creek, SC 29445-6406Phone(843) 996-1471Fax(843) 808-6986Mailing LocationMailing AddressPO Box 1119, Goose Creek, SC 29445-1119Phone(843) 996-1471Fax(843) 808-6986Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense9709South Carolina