Individual
TERI ARLANA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
332 W MAIN ST, LATTA, SC 29565-1510
(843) 474-1207
Mailing address
332 W MAIN ST, LATTA, SC 29565-1510
(843) 474-1207
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
07/30/2025
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