Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 1202 | SC |
NPI | 1285711440 |
---|---|
Provider Name | Teresa P Jenkins |
First Address | Columbia, SC 29212-8635 |
Second Address | Columbia, SC 29212-8635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1202 | DOCTOR OF CHIROPATHY (01) | SC |