Individual
EMILY C PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
638 US HIGHWAY 68 W, BENTON, KY 42025-7423
(270) 527-4526
Mailing address
1145 MAGNESS RD, BENTON, KY 42025-5562
(270) 804-5634
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
281905
KY
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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