Organization
KIDZONE OT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JONES OTR/L (OCCUPATIONAL THERAPIST)
(843) 729-2902
Entity
Organization
Contact information
Practice address
519 FLYCATCHER DR, GOOSE CREEK, SC 29445-7341
(843) 729-2902
(843) 628-3560
Mailing address
519 FLYCATCHER DR, GOOSE CREEK, SC 29445-7341
(843) 729-2902
(843) 628-3560
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT3009
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1570
—
SC
Enumeration date
04/27/2017
Last updated
04/27/2017
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