Individual
JAMES DERRICK GERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2804 MILLCREST DR, FLORENCE, SC 29501-8970
(843) 495-8388
Mailing address
2804 MILLCREST DR, FLORENCE, SC 29501-8970
(843) 495-8388
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
004077321
SC
Other
Enumeration date
05/23/2026
Last updated
05/23/2026
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