Individual
ALIZA G HAITHCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
401 LAMBERT RD, BISCOE, NC 27209-9002
(910) 428-2117
Mailing address
304 APPLE ORCHARD RD, MOUNT GILEAD, NC 27306-9579
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1006
NC
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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