Individual
DENISE TICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
131 MILLER ST, WINSTON SALEM, NC 27103-2508
(336) 716-8097
Mailing address
131 MILLER ST, WINSTON SALEM, NC 27103-2508
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2405
NC
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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