Individual
ALEXX PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 GRANT ST, GARY, IN 46402-6001
(219) 886-4000
Mailing address
6653 CRESTWELL LN, INDIANAPOLIS, IN 46268-4885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002427A
IN
Other
Enumeration date
02/20/2018
Last updated
08/16/2019
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