Individual
MRS. JENNIFER RENEE HEROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1051 BLOSSOM ST, SUITE 201, COLUMBIA, SC 29208-0001
(803) 777-0178
(803) 777-1258
Mailing address
108 LOSKIN LN, LEXINGTON, SC 29073-7182
(803) 777-0178
(803) 777-1258
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
729
SC
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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