Individual
TRACEY L MANASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 DRIVE IN LANE, UNIT D, MONCKS CORNER, SC 29461
(843) 761-6732
(843) 761-6734
Mailing address
2347 TALL SAIL DR APT L, CHARLESTON, SC 29414-6639
(843) 364-1747
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4479
SC
Other
Enumeration date
04/24/2009
Last updated
04/24/2009
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