Individual
JORI GRACE BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2470 MALL DR UNIT CD, NORTH CHARLESTON, SC 29406-6514
(843) 207-4721
Mailing address
124 GAZANIA WAY, CHARLESTON, SC 29414-7989
(678) 863-8877
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PR48929
SC
Other
Enumeration date
02/16/2019
Last updated
02/16/2019
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