Individual
JENNIFER E BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2244 LANGFORDVILLE RD, RIDGELAND, SC 29936-3534
(423) 608-2821
Mailing address
2244 LANGFORDVILLE RD, RIDGELAND, SC 29936-3534
(423) 608-2821
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2116
SC
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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