Individual
MR. JEFFREY WALTER HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
990 ACADEMY RD, WALTERBORO, SC 29488-9266
(843) 893-8122
(843) 549-2650
Mailing address
990 ACADEMY RD, WALTERBORO, SC 29488-9266
(843) 893-8122
(843) 549-2650
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
165834
SC
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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