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Individual

JACOB SOOTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2061 HIGHWAY 52, MONCKS CORNER, SC 29461-5017
(316) 208-4591
Mailing address
2061 HIGHWAY 52, MONCKS CORNER, SC 29461-5017
(843) 761-8800

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
08/09/2019
Last updated
03/01/2021
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