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Individual

MR. EDWIN DARGAN ERVIN JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
3650 COALITION DR, MYRTLE BEACH, SC 29588-6183
(843) 293-7713
Mailing address
202 TIMBERLAKE DR, FLORENCE, SC 29501-9311

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
678
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TH0373
SC
Enumeration date
05/10/2006
Last updated
07/08/2007
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