Provider Demographics
NPI:1275097735
Name:MCCLENDON, JASMINE N (DPT, PT)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:N
Last Name:MCCLENDON
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:N
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 ATRIUM WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6301
Mailing Address - Country:US
Mailing Address - Phone:803-957-0404
Mailing Address - Fax:803-957-0404
Practice Address - Street 1:7800 RIVERS AVE STE 1240
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4067
Practice Address - Country:US
Practice Address - Phone:843-277-0710
Practice Address - Fax:843-573-7412
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist