Organization
ELEVATED PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY LEANN MANASCO PT (PHYSICAL THERAPIST)
(843) 364-1747
Entity
Organization
Contact information
Practice address
44 MARKFIELD DR STE B, CHARLESTON, SC 29407-7908
(843) 364-1747
Mailing address
2347 TALL SAIL DR APT L, CHARLESTON, SC 29414-6639
(843) 364-1747
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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