Individual ProviderSamuel EngebosePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2418 Nnptc Circle, Goose Creeek, SC 29445(843) 577-5011PECOS EnrollmentBased on the most recent information from CMS, provider Samuel Engebose 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 ID1942862313Provider TypeIndividualFull NameEngebose, SamuelCredentialPT, DPTGenderMaleSole ProprietorNoEnumeration Date7/5/2019Last Updated7/5/2019Contact InformationPractice LocationPractice Address2418 Nnptc Circle, Goose Creeek, SC 29445Phone(843) 577-5011FaxUnlisted FaxMailing LocationMailing Address109 Bee Street, Rehab Med. 117, Charleston, SC 29401PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseP18819North CarolinaCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerNorth Carolina