Individual
JESSICA FOXWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
220 VINEYARD LAKE CIR, CONWAY, SC 29527-7878
(843) 845-2410
Mailing address
220 VINEYARD LAKE CIR, CONWAY, SC 29527-7878
(843) 845-2410
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1842
SC
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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