Individual
JENNIFER LYNN MIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8538 KENNESTONE LN, NORTH CHARLESTON, SC 29420-6843
(843) 725-9886
Mailing address
8538 KENNESTONE LN, NORTH CHARLESTON, SC 29420-6843
(843) 725-9886
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11823
SC
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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