Individual
JACLYN M BANKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
150 TANNER RD STE B, GREENVILLE, SC 29607-5917
(864) 297-0220
(864) 297-2335
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
(423) 238-7217
(423) 362-8684
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8983
SC
225100000X
Physical Therapist
PT013272
GA
225100000X
Physical Therapist
PT26642
FL
2255A2300X
Athletic Trainer
AL2464
FL
2255A2300X
Athletic Trainer
AT001852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004041600
—
FL
Enumeration date
02/14/2011
Last updated
09/05/2018
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