Individual
PAUL F JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2233 NORTHWOODS BLVD, N CHARLESTON, SC 29405
(866) 448-1641
Mailing address
PO BOX 751137, CHARLOTTE, NC 28275-1137
(866) 448-1641
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A857
—
Other
Enumeration date
07/28/2006
Last updated
02/25/2008
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