Individual
JERMAINE LECLERC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
AA000016
DC
367H00000X
Anesthesiologist Assistant
Primary
96
SC
367H00000X
Anesthesiologist Assistant
AA121
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
10/21/2008
Last updated
10/27/2022
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