Individual
GABRIEL BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
634 BACONS BRIDGE RD, SUMMERVILLE, SC 29485-4102
(843) 821-2272
(843) 821-2274
Mailing address
4302 PINE TRAIL LN, SUMMERVILLE, SC 29486-5357
(513) 477-8891
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8271
SC
Other
Enumeration date
08/01/2016
Last updated
08/01/2016
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