Individual
MYIA MCKENZIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
134 ADAMS TERRACE CT, WEST COLUMBIA, SC 29172-2600
(803) 397-1231
Mailing address
134 ADAMS TERRACE CT, WEST COLUMBIA, SC 29172-2600
(803) 397-1231
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
SC
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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