Individual ProviderKirby BroomePhysical 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 Kirby Broome 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 ID1558928523Provider TypeIndividualFull NameBroome, KirbyCredentialPT, DPTGenderMaleSole ProprietorNoEnumeration Date5/23/2019Last 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 ProvidersLicense9667South Carolina