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Individual

MICHELE MAUSOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1215 ALICE DR, SUMTER, SC 29150-1905
(803) 774-5201
Mailing address
1185 EISENHOWER CT, APT 104, SUMTER, SC 29150-2010
(989) 980-7835

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2243
SC

Other

Enumeration date
04/22/2009
Last updated
04/22/2009
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