Individual
MRS. GAIL MARIE DETJEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
912 INLET SQUARE DR, MURRELLS INLET, SC 29576-7812
(843) 350-6150
(843) 823-7309
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10571
SC
225100000X
Physical Therapist
9964-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH4541
—
SC
Enumeration date
04/01/2008
Last updated
07/06/2021
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