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Individual

DR. RICHARD ANTHONY DEFALCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT, OCS, CSCS

Contact information

Practice address
1301 48TH AVE N STE D, MYRTLE BEACH, SC 29577-5427
(843) 839-1300
(843) 839-1320
Mailing address
PO BOX 2397, PAWLEYS ISLAND, SC 29585-2397
(843) 235-0200
(843) 235-0242

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10205
NC
225100000X
Physical Therapist
40QA01172100
NJ
225100000X
Physical Therapist
Primary
6295
SC
225100000X
Physical Therapist
P10205
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00892030
RAILROAD MEDICARE PRS 3 LLC
SC
01
P01046409
RAILROAD MEDICARE PTAN
SC
01
P01245604
RAILROAD MEDICARE PRS 4 LLC
SC
05
TH2436
SC
Enumeration date
03/06/2007
Last updated
01/13/2026
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