Provider Demographics
NPI:1639438815
Name:ST CLAIR, JASON (PT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ST CLAIR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:214 SAINT JAMES AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2974
Mailing Address - Country:US
Mailing Address - Phone:843-793-4466
Mailing Address - Fax:843-793-3786
Practice Address - Street 1:214 SAINT JAMES AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2974
Practice Address - Country:US
Practice Address - Phone:843-793-4466
Practice Address - Fax:843-793-3786
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic