Individual
MRS. JENNIFER G D'ANTONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3231 SUNSET BLVD, SUITE C, WEST COLUMBIA, SC 29169-3483
(803) 454-8500
(803) 454-8505
Mailing address
3231 SUNSET BLVD, SUITE C, WEST COLUMBIA, SC 29169-3483
(803) 454-8500
(803) 454-8505
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1006
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307PA
—
SC
Enumeration date
07/14/2005
Last updated
03/21/2013
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