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1275650426
PHILLIP DWAYNE FUGATE
EASLEY, SC
NPI
1275650426
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: SC 1067)
Enumeration Date
2007-03-23
Last Update Date
2007-07-08
Business Address
MR. PHILLIP DWAYNE FUGATE P.T.A.
101 GRACE DR
EASLEY, SC 29640-9088
Phone number: 864-679-3100
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Mailing Address
MR. PHILLIP DWAYNE FUGATE P.T.A.
2467 BEAVER CREEK LN
AIKEN, SC 29803-4101
Phone number: 803-649-0446
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