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Individual
TIM JAMES PUCKETT
Active
Individual
TIM JAMES PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10101PT
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10101PT
STATE OF ARIZONA PHYSICAL THERAPY LICENSE NUMBER
AZ
Enumeration date
11/28/2012
Last updated
05/28/2026
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