NPI 1497204739

Jack Mixon, RKT

Practitioner Kinesiotherapist Greenville, SC

Practice location

Address: 41 Park Creek Dr, Greenville, SC 29605-4270
Phone: (864) 299-1600

Registered specialties

Kinesiotherapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 226300000X Licence 1982 (MS)

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Registry record

NPI: 1497204739
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Sep 2016
Record last updated: 28 Sep 2016

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.