Healthcare Provider Details

I. General information

NPI: 1457701195
Provider Name (Legal Business Name): MICHAEL ANTHONY CATANZANO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 FORUM DR SUITE 13
COLUMBIA SC
29229-7943
US

IV. Provider business mailing address

10 WILLIAM POPE DR SUITE 3
BLUFFTON SC
29909-7549
US

V. Phone/Fax

Practice location:
  • Phone: 803-509-6880
  • Fax: 803-509-6881
Mailing address:
  • Phone: 843-705-9440
  • Fax: 843-705-9445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8220
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: