| Doctor Name: | TRACEY L MANASCO |
| NPI Number: | 1316181100 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4479 |
| Business Practice Address: | 412 Drive In Lane, Unit D Moncks Corner, SC - 29461 |
| Business Phone Number: | 8437616732 |
| Business Fax Number: | 8437616734 |
| Mailing Address: | 2347 Tall Sail Dr Apt L, CHARLESTON |
| State: | SC |
| Postal Code: | 294146639 |
| Phone Number: | 8433641747 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2009 |
| NPI Last Update Date: | 04/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 4479 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |