Individual
MR. DWAYNE M DUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1620 BROUGHTON ST, ORANGEBURG, SC 29115-4867
(803) 534-4050
(803) 534-0408
Mailing address
1620 BROUGHTON ST, ORANGEBURG, SC 29115
(803) 534-4050
(803) 534-0408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1458
SC
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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