Individual
SUSAN LYNNE BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1001 N FRASER ST, GEORGETOWN, SC 29440-2848
(843) 668-4329
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7296
SC
Other
Enumeration date
08/30/2006
Last updated
11/04/2015
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