Individual
JENNIE ELLIS HAITHCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
205 MIDLAND PKWY, SUMMERVILLE, SC 29485-8122
(843) 875-7163
(843) 875-7169
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(800) 944-9782
(610) 438-2024
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5762
SC
Other
Enumeration date
05/10/2010
Last updated
05/10/2010
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