Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 5041 | SC |
NPI | 1114321965 |
---|---|
Provider Name | Teresa Marie Jemming |
First Address | Sumter, SC 29154-9475 |
Second Address | Sumter, SC 29154-9475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2014 |
Last Update Date | 21/10/2014 |