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Portia Jackson
NPI 1265113054 · on the registry since 2023 · sole proprietor
Practice
- Address
- 887 Pine Log Ford Rd
Travelers Rest, SC 29690 - Phone
- (803) 467-8687
Registry record
- Primary taxonomy
- 342000000X
342000000X
- Licence states on file
- SC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-07-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in South Carolina