Individual
GRAYSON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3040 HIGHWAY 17 BYP N STE A, MOUNT PLEASANT, SC 29466-9438
(843) 388-7667
(843) 388-7877
Mailing address
141 ATRIUM WAY, COLUMBIA, SC 29223-6301
(843) 388-7667
(843) 388-7877
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10570
SC
Other
Enumeration date
02/22/2021
Last updated
12/07/2021
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