Individual
LYNN S DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1 BISHOP GADSDEN WAY, CHARLESTON, SC 29412-3506
(843) 406-6302
(843) 406-6540
Mailing address
1476 LONG GROVE DR, STE 1, MT PLEASANT, SC 29464-7571
(843) 406-6302
(843) 406-6540
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1480
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650024090
PHYSICAL THERAPIST/ RR#
SC
Enumeration date
07/18/2006
Last updated
04/18/2017
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