Individual
PHILIP LIDE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
901 E CHEVES ST, SUITE 510, FLORENCE, SC 29506-2716
(843) 777-5043
Mailing address
901 E CHEVES ST, SUITE 510, FLORENCE, SC 29506-2716
(843) 777-5043
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
5969
SC
2251X0800X
Orthopedic Physical Therapist
Primary
5969
SC
Other
Enumeration date
08/25/2009
Last updated
08/25/2009
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