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Individual

JIMMY L BATTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
943 PINE LOG RD, AIKEN, SC 29803-7330
(803) 649-9797
Mailing address
943 PINE LOG RD., WARRENVILLE, SC 29851
(803) 649-9797

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2068
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2068
STATE LICENSE
SC
Enumeration date
01/12/2007
Last updated
10/28/2015
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