Organization
JUMP START THERAPY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANNELL CLARK SUMMERS MA, CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(803) 378-3768
Entity
Organization
Contact information
Practice address
803 DAHLIA CT, JACKSONVILLE, NC 28546-4627
(803) 378-3768
Mailing address
803 DAHLIA CT, JACKSONVILLE, NC 28546-4627
(803) 378-3768
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8967
NC
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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