Individual
THERESA LYNN PAQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2200 CROW LN, MYRTLE BEACH, SC 29577-1663
(860) 416-8617
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7713
SC
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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