NPI 1093989006

Jon R Jacobs

Organisation Specialist North Charleston, SC

Practice location

Address: 9213 University Blvd STE D, North Charleston, SC 29406-9145
Phone: (843) 797-6564
Fax: (843) 572-9165

Authorised official

Name: Shannon Leigh Smith
Title: Office Manager
Phone: (843) 797-6564

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 199702336 (SC)

Other Specialist providers in South Carolina →

Registry record

NPI: 1093989006
Entity type: Organization
NPI issued: 22 Apr 2008
Record last updated: 22 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.