Individual
JEREMY GORDON PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2500 ELMS CENTER ROAD, NORTH CHARLESTON, SC 29406
(843) 302-8845
(843) 569-5872
Mailing address
PO BOX 118008, NORTH CHARLESTON, SC 29423-8008
(843) 302-8845
(843) 569-5872
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7197
SC
Other
Enumeration date
08/09/2012
Last updated
08/10/2012
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