IndividualActive
Jack Mixon, RKT
NPI 1497204739 · Kinesiotherapist · Greenville, SC
Provider details
- NPI number
- 1497204739
- Entity type
- Individual
- Primary specialty
- KinesiotherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- RKT
- Sex
- Male
- Sole proprietor
- No
- License
- 1982 (MS)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
41 Park Creek Dr
Greenville, SC 29605-4270
Phone: (864) 299-1600
Approximate (ZIP-level) locationGet directions
Mailing address
41 Park Creek Dr
Greenville, SC 29605-4270
Registry dates
- Enumerated
- 2016-09-28
- Last updated
- 2016-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.