Provider Demographics
NPI:1427265099
Name:THE SANTANGELO CLINIC PA
Entity type:Organization
Organization Name:THE SANTANGELO CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:SANTANGELO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:843-881-6556
Mailing Address - Street 1:564 BELLE STATION BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8225
Mailing Address - Country:US
Mailing Address - Phone:843-881-6556
Mailing Address - Fax:
Practice Address - Street 1:564 BELLE STATION BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8225
Practice Address - Country:US
Practice Address - Phone:843-881-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty