Healthcare Provider Details

I. General information

NPI: 1427265099
Provider Name (Legal Business Name): THE SANTANGELO CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 BELLE STATION BLVD
MT PLEASANT SC
29464-8225
US

IV. Provider business mailing address

564 BELLE STATION BLVD
MT PLEASANT SC
29464-8225
US

V. Phone/Fax

Practice location:
  • Phone: 843-881-6556
  • Fax:
Mailing address:
  • Phone: 843-881-6556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: FRANCIS ALFRED SANTANGELO JR.
Title or Position: DIRECTOR
Credential: P.T.
Phone: 843-881-6556