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1083712590
DIANE M LODGE
SUMMERVILLE, SC
NPI
1083712590
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: SC 2288)
Enumeration Date
2006-09-20
Last Update Date
2007-07-08
Business Address
-- DIANE M LODGE PT
950 TRAVELERS BLVD
SUMMERVILLE, SC 29485-8213
Phone number: 843-832-8481
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Mailing Address
-- DIANE M LODGE PT
2222 SULLIVAN TRL
EASTON, PA 18040-7958
Phone number:
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