Individual
LEONARD THOMAS MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1291 PALM COVE DR, CHARLESTON, SC 29492-8006
(843) 324-1456
Mailing address
1291 PALM COVE DR, CHARLESTON, SC 29492-8006
(843) 324-1456
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1573
SC
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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