Individual
JORDAN BROWN OATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
379 PINEHAVEN STREET EXT, LAURENS, SC 29360-2672
(864) 984-6584
(864) 984-6464
Mailing address
109 HUDDERS CREEK WAY, SIMPSONVILLE, SC 29680-3543
(864) 360-0102
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2707
SC
Other
Enumeration date
01/03/2012
Last updated
05/09/2013
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