Individual
JESSIE MIZZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT/DPT
Contact information
Practice address
119 OFFICE PARK DR, ORANGEBURG, SC 29118-2407
(803) 937-5605
(803) 937-6256
Mailing address
3374 RAILROAD AVE, BAMBERG, SC 29003-8248
(803) 245-0808
(803) 245-0974
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12212
SC
Other
Enumeration date
04/18/2024
Last updated
04/24/2024
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