Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1374 | SC |
NPI | 1063600823 |
---|---|
Provider Name | Susan Bell Santangelo |
First Address | Charleston, SC 29425 |
Second Address | Charleston, SC 29425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2007 |
Last Update Date | 05/10/2007 |