Individual
EVELYN VILLARREAL LACLEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2457 GUM BRANCH RD # 600-800, JACKSONVILLE, NC 28540-4008
(252) 228-4643
Mailing address
2457 GUM BRANCH RD # 600-800, JACKSONVILLE, NC 28540-4008
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1337128
TX
225100000X
Physical Therapist
Primary
CP029624T
NC
225100000X
Physical Therapist
PT61393182
WA
Other
Enumeration date
10/02/2020
Last updated
03/10/2024
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