Individual
KANISHA JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 HARD SCRABBLE RD, COLUMBIA, SC 29229-9159
(803) 315-9867
Mailing address
2919 NETWORK PL, LUTZ, FL 33559-3133
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
SC
Other
Enumeration date
10/02/2018
Last updated
11/05/2024
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