DYLAN ROGER HACKLEY

COLUMBIA, SC
NPI1679248074
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: SC  4673)
Enumeration Date2021-08-09
Last Update Date2021-08-09
Business Address
DYLAN ROGER HACKLEY PTA
1715 BLANDING ST
COLUMBIA, SC 29201-3441
Phone number: 803-799-3926
Mailing Address
DYLAN ROGER HACKLEY PTA
1715 BLANDING ST
COLUMBIA, SC 29201-3441
Phone number: