Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK MIXON, RKT
ActiveOccupational Therapist · GREENVILLE, SC
Registration Details
- NPI Number
- 1497204739
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 28, 2016 (9.565873345156 yrs)
- Last Updated
- Sep 28, 2016
- License
-
1982 (MS)
Practice Information
- Address
-
41 PARK CREEK DRGREENVILLE, SC, 296054270Browse SC providers · Browse ZIP 29605
- Phone
- 8642991600
- Primary Specialty
-
Occupational Therapist
226300000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.