Individual
HEATHER D BACCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
626 SWING GATE RD, HERTFORD, NC 27944-8771
(252) 339-5251
Mailing address
626 SWING GATE RD, HERTFORD, NC 27944-8771
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A7095
NC
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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