SAMUEL COLLINS JACKSON

MT PLEASANT, SC
NPI1811511199
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: SC  10222)
Additional Taxonomies225100000X Physical Therapist
Enumeration Date2020-06-03
Last Update Date2022-10-20
Business Address
SAMUEL COLLINS JACKSON DPT
1125 LANDAU LN
MT PLEASANT, SC 29466-7300
Phone number: 843-375-5448
Mailing Address
SAMUEL COLLINS JACKSON DPT
5111 N RHETT AVE
NORTH CHARLESTON, SC 29405-4219
Phone number: 843-804-9478