Provider Demographics
NPI:1922207380
Name:DISCAYA, PHILIP ALONZO (PT)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:ALONZO
Last Name:DISCAYA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 MOUNT VERNON LN
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8710
Mailing Address - Country:US
Mailing Address - Phone:864-486-8355
Mailing Address - Fax:
Practice Address - Street 1:63 BLACKSTOCK RD
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-1835
Practice Address - Country:US
Practice Address - Phone:864-472-9055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26202251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics