Healthcare Provider Details

I. General information

NPI: 1982503231
Provider Name (Legal Business Name): MARGUERITE LYNN WOOLDRIDGE MASSAGE THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 DEWITT DR STE C
LUGOFF SC
29078-9069
US

IV. Provider business mailing address

728 DEWITT DR STE C
LUGOFF SC
29078-9069
US

V. Phone/Fax

Practice location:
  • Phone: 803-973-0336
  • Fax:
Mailing address:
  • Phone: 803-973-0336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7357
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: