Individual
CHARLENE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 W EVANS ST STE 202, FLORENCE, SC 29501-3388
(843) 407-1023
Mailing address
1001 W EVANS ST STE 202, FLORENCE, SC 29501-3388
(843) 407-1023
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10009
SC
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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