Organization
STASI'S LOW VISION THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STASI ANN GORMLEY OTR (OWNER/OCCUPATIONAL THERAPIST)
(843) 345-2769
Entity
Organization
Contact information
Practice address
602 HIDDEN BLVD, MOUNT PLEASANT, SC 29464-8129
(843) 345-2769
Mailing address
602 HIDDEN BLVD, MOUNT PLEASANT, SC 29464-8129
(843) 345-2769
Taxonomy
Speciality
Code
Description
License number
State
225XL0004X
Low Vision Occupational Therapist
Primary
2491
SC
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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