JEFFREY WALTER HERNDON

WALTERBORO, SC
NPI1649604000
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy302F00000X Exclusive Provider Organization
(Licence: SC  165834)
Enumeration Date2013-08-21
Last Update Date2013-08-21
Business Address
Mr. JEFFREY WALTER HERNDON
990 ACADEMY RD
WALTERBORO, SC 29488-9266
Phone number: 843-893-8122
Mailing Address
Mr. JEFFREY WALTER HERNDON
990 ACADEMY RD
WALTERBORO, SC 29488-9266
Phone number: 843-893-8122