Individual
MRS. JESSICA CAROLANN BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
125 DOUGHTY STREET SUITE 190, CHARLESTON, SC 29425-3208
(843) 792-5217
Mailing address
125 DOUGHTY ST STE 190, CHARLESTON, SC 29403-5739
(513) 544-6421
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MPA.3373
SC
Other
Enumeration date
12/19/2019
Last updated
03/10/2022
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