Individual
PETRINA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1008 RION RD, WINNSBORO, SC 29180-6785
(803) 402-5516
Mailing address
1008 RION RD, WINNSBORO, SC 29180-6785
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/27/2021
Last updated
12/27/2021
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