Individual
JACLYN BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
921 S LONG DR STE 101, ROCKINGHAM, NC 28379-4874
(910) 417-3850
Mailing address
921 S LONG DR STE 101, ROCKINGHAM, NC 28379-4874
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03285
NC
Other
Enumeration date
01/06/2012
Last updated
10/05/2022
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