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Organization
JAG28 LLC
Active
Organization
JAG28 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES JOSEPH GROVE (PRESIDENT)
(623) 670-0399
Entity
Organization
Contact information
Practice address
420 HERLONG AVE S STE 104, ROCK HILL, SC 29732-1091
(839) 274-3013
(839) 274-3014
Mailing address
4425 SHARON RD UNIT S802, CHARLOTTE, NC 28211-3691
(162) 367-0039
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/13/2024
Last updated
09/18/2026
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