Individual
JESSICA LAWANDA WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
21937 MAIN ST, HYDEN, KY 41749
(606) 672-6683
Mailing address
PO BOX 2121, HYDEN, KY 41749-2121
(606) 672-6683
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004980
KY
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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