Individual
SAMUEL COLLINS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1125 LANDAU LN, MT PLEASANT, SC 29466-7300
(843) 375-5448
Mailing address
5111 N RHETT AVE, NORTH CHARLESTON, SC 29405-4219
(843) 804-9478
(843) 804-9020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10222
SC
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/03/2020
Last updated
10/20/2022
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