Individual
JARED JACKSON IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 E JEFFERSON ST, DILLON, SC 29536-3019
(843) 506-9763
Mailing address
607 E JEFFERSON ST, DILLON, SC 29536-3019
(843) 506-9763
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
SC
Other
Enumeration date
08/08/2025
Last updated
08/08/2025
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