Individual
JORY GIBBONS CROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
AIKEN SPECIALTY SERVICES, 209 ABBEVILLE AVE NW, AIKEN, SC 29801
(803) 306-1433
Mailing address
86 WREN ST, BARNWELL, SC 29812-1529
(803) 259-5762
(803) 259-3250
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1896
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1646PA
—
SC
01
—
1896
SC MEDICAL BOARD LICENSE NUMBER
SC
Enumeration date
02/22/2013
Last updated
01/11/2024
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