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Aundra Jackson
Prosthetic/Orthotic Supplier in Columbia, South Carolina
NPI 1518733278

Aundra Jackson is a Prosthetic/Orthotic Supplier based in Columbia, SC. Aundra Jackson practices in Columbia, SC. The NPI Number for Aundra Jackson is 1518733278 and holds a License No. (South Carolina).

The current practice location address for Aundra Jackson is 494 Blue Garden Way, Columbia, SC and can be reached out via phone at 803-271-1462 and via fax at 267-633-8881.

Location: 494 Blue Garden Way, Columbia, SC, 29223-8052
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518733278
Provider Name
Aundra Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
494 Blue Garden Way, Columbia, SC, 29223-8052
Phone Number
803-271-1462
Fax Number
267-633-8881
Provider Enumeration Date
12/04/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
494 Blue Garden Way
City
Columbia
State
South Carolina
Zip
29223-8052
Phone Number
803-271-1462
Fax Number
267-633-8881
person
Provider Business Mailing Address Details
Address
494 Blue Garden Way
City
Columbia
State
South Carolina
Zip
29223-8052
Phone Number
803-271-1462
Fax Number
267-633-8881
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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