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Individual

AMY R JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1132 SPRING ST, GREENWOOD, SC 29646-3859
(864) 725-1680
(864) 725-1683
Mailing address
104 WELLS AVE, GREENWOOD, SC 29646-3837
(864) 725-4673
(864) 725-7424

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82152
SC

Other

Enumeration date
05/21/2019
Last updated
07/25/2024
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