Individual
JESSICA A. POWNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6605
Mailing address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
11/25/2013
Last updated
03/25/2025
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