Individual
TRACEY ROGERS BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
711 CHESTERFIELD HWY, CHERAW, SC 29520-7002
(843) 537-7881
Mailing address
123 WEXHURST RD, COLUMBIA, SC 29212-8515
(803) 447-3725
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3077
SC
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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