# LEGACY PHYSIATRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871168302
- **Authorized official:** DR. ANGELICA MARIA SOBERON-CASSAR MD (OWNER)
- **Authorized official phone:** (864) 546-0153

## Contact information

- **Practice address:** 126 VERDAE CREST DR, GREENVILLE, SC 29607-3961
- **Practice address phone:** (864) 546-0153
- **Mailing address:** 126 VERDAE CREST DR, GREENVILLE, SC 29607-3961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/26/2021
- **Last updated:** 05/26/2021