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1164026837
CATIE DIANE JACKSON
WEST COLUMBIA, SC
NPI
1164026837
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Additional Taxonomies
363AS0400X Physician Assistant, Surgical
Enumeration Date
2020-11-24
Last Update Date
2023-04-05
Business Address
CATIE DIANE JACKSON PA-C
2720 SUNSET BLVD
WEST COLUMBIA, SC 29169-4810
Phone number: 803-791-2000
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Mailing Address
CATIE DIANE JACKSON PA-C
411 MOSS CREEK DR
CAYCE, SC 29033-1923
Phone number:
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