Individual
JACOB KINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2070 NORTHBROOK BLVD, NORTH CHARLESTON, SC 29406-9252
(843) 824-2183
(843) 553-3221
Mailing address
586 LONE TREE DR, MOUNT PLEASANT, SC 29464-8170
(843) 884-7880
(843) 884-6635
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7395
SC
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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