Jack Alibert Legrand Jr.
Health Educator in Prosperity, SC. Individual provider (NPI-1).
NPI number1982105243
StatusActive
Last updated in NPPESFeb 22, 2018
Details
- NPI
- 1982105243
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jack Alibert Legrand Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 22, 2018
- Last updated
- Feb 22, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174H00000X | Health Educator | – | – | Yes |
Practice location
600 N Wheeler AveProsperity, SC 29127-9332
Phone 803-364-4852
Mailing address
Po Box 630Prosperity, SC 29127-0630
Phone 803-364-4852
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