Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Stacey Rena Vandall, PTA

Individual provider Physical Therapy Assistant · NPI 1679786313

Miss. Stacey Rena Vandall, PTA is a Physical Therapy Assistant in Myrtle Beach, South Carolina. Licensed in South Carolina. Registered with an NPI since 2007.

Licensed in
SC
In the registry since
2007
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

455 Sunnehanna Dr Box 384
Myrtle Beach, SC 29588-5365
Phone: (843) 340-4478
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 1504 (SC)

Record details

NPI number1679786313
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedMay 8, 2007
Last updated in NPPESSeptember 30, 2016

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