Organization
DUCKETT PHYSICAL THERAPY & SPORTS REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE M. DUCKETT PT, MTC (OWNER/DIRECTOR)
(803) 534-4050
Entity
Organization
Contact information
Practice address
1620 BROUGHTON ST., ORANGEBURG, SC 29115
(803) 534-4050
(803) 534-0408
Mailing address
1620 BROUGHTON ST., ORANGEBURG, SC 29115
(803) 534-4050
(803) 534-0408
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1458
SC
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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