Individual
MRS. JIMAKI WITHERSPOON ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1166 CAMP CREEK RD, LANCASTER, SC 29720-8558
(803) 804-0440
Mailing address
1166 CAMP CREEK RD, LANCASTER, SC 29720-8558
(803) 804-0440
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4579
SC
Other
Enumeration date
09/15/2008
Last updated
07/21/2022
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