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General NPI Number Information
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NPI Number | 1841717832
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Entity Type | Individual
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Provider Name | JACKIE R HILL
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Gender | Female
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 08/29/2017
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Provider Practice Location Address
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Address Line | 704 S ALABAMA AVE
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City | CHESNEE
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State | SC
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Zip | 29323-1706
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Country | US
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Telephone | 864-680-2628
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Fax | 864-680-2628
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Provider Business Mailing Address
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Address Line | 250 WALL DR
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City | CHESNEE
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State | SC
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Zip | 29323-8113
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Country | US
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Telephone | 864-680-2628
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7611
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License Number State | SC
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