Healthcare Provider Details

I. General information

NPI: 1760311377
Provider Name (Legal Business Name): MR. JAMES MCKINLEY JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4371 CHARLOTTE HWY STE 3
CLOVER SC
29710-7059
US

IV. Provider business mailing address

1110 AMESBURY CT APT 204
CLOVER SC
29710-0494
US

V. Phone/Fax

Practice location:
  • Phone: 803-526-3550
  • Fax:
Mailing address:
  • Phone: 803-526-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12268
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: