Individual
MR. GARY SHANE ZACCAGNINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5502 MEMORIAL BLVD UNIT 2, SAINT GEORGE, SC 29477-2286
(843) 638-5122
(843) 638-5126
Mailing address
5502 MEMORIAL BLVD UNIT 2, SAINT GEORGE, SC 29477-2286
(843) 638-5122
(843) 638-5126
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2139
SC
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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