Individual
TINE DYNJAN LIVESAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
401 SEACOAST PKWY UNIT D, MOUNT PLEASANT, SC 29464-8263
(843) 969-2201
(843) 969-2202
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8154
SC
Other
Enumeration date
10/27/2016
Last updated
07/17/2024
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