Individual
MRS. JESSICA RIDENHOUR KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5705 FAYETTEVILLE RD, DURHAM, NC 27713-5318
(919) 424-5078
Mailing address
711 FAITH WAY RD, MEBANE, NC 27302-8868
(336) 263-3130
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9885
NC
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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