Individual
JONATHAN BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 BROAD ST, CAMDEN, SC 29020-2225
(803) 432-5103
Mailing address
5000 FOREST DR APT 2213, COLUMBIA, SC 29206-6502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37089
SC
Other
Enumeration date
07/27/2017
Last updated
07/27/2017
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