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1235346172
REVONDA LASHAWN JESSUP
GASTONIA, NC
NPI
1235346172
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
213ES0103X Podiatrist, Foot & Ankle Surgery
(Licence: NC 505)
Enumeration Date
2007-05-17
Last Update Date
2023-01-24
Business Address
REVONDA LASHAWN JESSUP D.P.M.
2721 X RAY DR
GASTONIA, NC 28054-7491
Phone number: 704-874-2255
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Mailing Address
REVONDA LASHAWN JESSUP D.P.M.
200 E 2ND AVE
GASTONIA, NC 28052-4358
Phone number: 704-874-1936
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