Provider Demographics
NPI:1124271473
Name:GALLOWAY-COKER, DARILYN VIRGINIA (DPT)
Entity type:Individual
Prefix:
First Name:DARILYN
Middle Name:VIRGINIA
Last Name:GALLOWAY-COKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PINE LOOP DR
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-8642
Mailing Address - Country:US
Mailing Address - Phone:803-661-7948
Mailing Address - Fax:
Practice Address - Street 1:100 PINE LOOP DR
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-8642
Practice Address - Country:US
Practice Address - Phone:803-661-7948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5720225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist