Individual
JONTAY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
714 SAINT ANDREWS BLVD, CHARLESTON, SC 29407-7141
(843) 573-3333
Mailing address
714 SAINT ANDREWS BLVD, CHARLESTON, SC 29407-7141
(843) 573-3333
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4776
SC
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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