Individual
MACKENZIE GRAE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
38 BUSINESS CENTER DRIVE, PAWLEYS ISLAND, SC 29585
(843) 235-0200
Mailing address
PO BOX 2397, PAWLEYS ISLAND, SC 29585-2397
(843) 235-0200
(843) 235-0242
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12231
SC
Other
Enumeration date
02/20/2024
Last updated
01/12/2026
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