Individual
JESSICA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, GCS
Contact information
Practice address
1049 ANNA KNAPP BLVD, MOUNT PLEASANT, SC 29464-3133
(843) 972-0498
Mailing address
1049 ANNA KNAPP BLVD, MOUNT PLEASANT, SC 29464-3133
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
6497
SC
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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