Individual
CAROLYN E JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 BARKINGHAM LN STE C, GREENVILLE, SC 29607-5905
(864) 881-1712
(864) 435-9923
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8118
SC
Other
Enumeration date
01/08/2015
Last updated
03/17/2025
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