Individual
DR. JACKSON THOMAS PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
5860 YADKIN RD, FAYETTEVILLE, NC 28303-2668
(910) 491-5164
Mailing address
953 BUTLER DR, ERWIN, NC 28339-8519
(919) 451-0212
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10968
SC
225100000X
Physical Therapist
Primary
P19589
NC
Other
Enumeration date
06/11/2020
Last updated
02/04/2026
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