Individual
JEREMY MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2470 MALL DR STE C, NORTH CHARLESTON, SC 29406-6514
(843) 207-4721
Mailing address
1832 N SMOKERISE WAY, MOUNT PLEASANT, SC 29466-8632
(563) 370-3256
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
51081
SC
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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