Individual
MR. JACK ALIBERT LEGRAND JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 N WHEELER AVE, PROSPERITY, SC 29127-9332
(803) 364-4852
Mailing address
PO BOX 630, PROSPERITY, SC 29127-0630
(803) 364-4852
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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