Doctor Name: | MR. LAWRENCE EDWARD BERTOLUCCI |
NPI Number: | 1396896254 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. , M.A. |
License Number: | 9962 |
Business Practice Address: | 38 Business Center Drive Pawleys Island, SC - 29585 |
Business Phone Number: | 8432350200 |
Business Fax Number: | 8432350242 |
Mailing Address: | Po Box 2397, PAWLEYS ISLAND |
State: | SC |
Postal Code: | 295852397 |
Phone Number: | 8432370200 |
Fax Number: | 8432350242 |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 12/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 9962 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
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 |