GWENNETTA PATRICE JACKSON

LEXINGTON, SC
NPI1316419443
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: SC  4800)
Enumeration Date2018-12-31
Last Update Date2018-12-31
Business Address
GWENNETTA PATRICE JACKSON COTA
700 DAVEGA DR
LEXINGTON, SC 29073-9698
Phone number: 803-796-8731
Mailing Address
GWENNETTA PATRICE JACKSON COTA
700 DAVEGA DR
LEXINGTON, SC 29073-9698
Phone number: 803-796-8731
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