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Individual

ALAYNA DEFALCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CEP

Contact information

Practice address
1320 501 BUSINESS, UNIT E, CONWAY, SC 29526
(843) 331-3424
Mailing address
1320 501 BUSINESS, UNIT E, CONWAY, SC 29526

Taxonomy

Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81-0765559
PREVENTATIVE MEDICINE FACILITY
SC
Enumeration date
01/22/2020
Last updated
01/22/2020
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