Individual
MARISSA SLATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9565 HIGHWAY 78 STE 102, LADSON, SC 29456-4118
(843) 314-5434
(888) 510-9156
Mailing address
9565 HWY 78 BLDG 700 STE 102, LADSON, SC 29456-4116
(843) 314-5434
(888) 510-9156
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 8191
SC
2251P0200X
Pediatric Physical Therapist
PT31544
FL
Other
Enumeration date
07/12/2016
Last updated
12/13/2017
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