Provider Demographics
NPI:1437263977
Name:DAGSAAN, CHRISTY DATUGAN (PT)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTY
Middle Name:DATUGAN
Last Name:DAGSAAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 2ND LOOP RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6123
Mailing Address - Country:US
Mailing Address - Phone:843-423-4888
Mailing Address - Fax:843-423-4849
Practice Address - Street 1:2307 EAST HWY 76
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-6351
Practice Address - Country:US
Practice Address - Phone:843-423-4888
Practice Address - Fax:843-423-4849
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2466OtherPT LICENSE NUMBER
SC2466OtherPT LICENSE NUMBER