Individual
MR. THOMAS GLYNN MCILWAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1120 BOARDWALK, SUMTER, SC 29150-1766
(803) 905-1316
Mailing address
1120 BOARDWALK, SUMTER, SC 29150-1766
(803) 905-1316
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3174
SC
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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