Individual
JACK AYRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 MEDICAL PARK RD, COLUMBIA, SC 29203-6808
(803) 434-6879
Mailing address
2 MEDICAL PARK RD, COLUMBIA, SC 29203-6808
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
LL89977
SC
Other
Enumeration date
04/04/2023
Last updated
07/11/2023
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