Individual
TALESIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1127 TRIPLE CROWN COURT, ELGIN, SC 29045
(254) 423-2666
Mailing address
1127 TRIPLE CROWN CT, ELGIN, SC 29045-7128
(254) 423-2666
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/01/2017
Last updated
07/21/2022
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