Individual
TORI JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
131 RINEHART WAY, AIKEN, SC 29803-1703
(803) 335-2200
(803) 649-7966
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 922-8251
(706) 922-6695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-11042
NC
363A00000X
Physician Assistant
Primary
4472
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4472
LICENSE
SC
Enumeration date
02/15/2021
Last updated
05/23/2024
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