Individual
JENNIFER THORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 JOHNNIE DODDS BLVD # A, MT PLEASANT, SC 29464-3030
(843) 884-7880
(843) 884-6635
Mailing address
586 LONE TREE DR, MT PLEASANT, SC 29464-1390
(843) 884-7880
(843) 884-6633
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5299
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1753
—
SC
05
—
TH1742
—
SC
Enumeration date
11/20/2006
Last updated
02/08/2021
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