Individual
MR. JOHNATHAN C VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRT
Contact information
Practice address
619 CREIGHTON DR, TAYLORS, SC 29687-3623
(864) 438-6405
Mailing address
619 CREIGHTON DR, TAYLORS, SC 29687-3623
(864) 438-6405
Taxonomy
Speciality
Code
Description
License number
State
2278H0200X
Home Health Certified Respiratory Therapist
Primary
RCP3247
SC
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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