| NPI | 1740657683 |
|---|---|
| Doing Business As | JACKSON VASCULAR SURGERY GREENVILLE |
| Entity Type | Organization |
| Authorized Contact | KELIN PENNEY Administrator Jackson Clinic 334-240-2335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-08-26 |