Individual
MARY R PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
428 E SCOTT AVE, KNOXVILLE, TN 37917-6362
(865) 318-1745
Mailing address
1219 AMBER GLADES LN, KNOXVILLE, TN 37922-9352
(865) 386-1700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7972
TN
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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