Individual
MR. JONATHAN W. SPACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SCAT, ATC
Contact information
Practice address
921 ASSEMBLY ST, COLUMBIA, SC 29208-8686
(803) 777-7000
Mailing address
2025 GERVAIS ST, COLUMBIA, SC 29204-1803
(704) 421-0395
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/30/2022
Last updated
07/16/2023
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