Individual
PHISON DAI VY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 OLD GREENVILLE HWY STE 500-1, CLEMSON, SC 29631-1787
(864) 722-6037
(864) 722-6038
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10468
SC
225100000X
Physical Therapist
Primary
CP032698T
NC
225100000X
Physical Therapist
—
—
Other
Enumeration date
12/17/2020
Last updated
11/05/2024
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