Provider Demographics
NPI:1457701195
Name:CATANZANO, MICHAEL ANTHONY (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:CATANZANO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WILLIAM POPE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7549
Mailing Address - Country:US
Mailing Address - Phone:843-705-9440
Mailing Address - Fax:843-705-9445
Practice Address - Street 1:130 FORUM DR
Practice Address - Street 2:SUITE 13
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7943
Practice Address - Country:US
Practice Address - Phone:803-509-6880
Practice Address - Fax:803-509-6881
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist