Individual
CORY THOMAS STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1105 12TH ST, CAYCE, SC 29033-3304
(803) 973-0100
(803) 973-0117
Mailing address
2829 MILLWOOD AVE, COLUMBIA, SC 29205-1261
(803) 851-3506
(803) 619-9551
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10047
SC
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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