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Individual

MICHAEL J SANTA LUCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1655 CANE BAY BLVD STE B, SUMMERVILLE, SC 29486-2397
(843) 719-7473
(843) 279-3251
Mailing address
1655 CANE BAY BLVD STE B, SUMMERVILLE, SC 29486-2397
(843) 719-7473
(843) 279-3251

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
001132
WV
2251X0800X
Orthopedic Physical Therapist
Primary
8042
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0158191-000
WV
Enumeration date
05/24/2005
Last updated
08/03/2020
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