Individual
MRS. JAMIE CAROL EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT,PTA
Contact information
Practice address
1304 DUGWAY CT, WAKE FOREST, NC 27587-5535
(304) 640-2980
Mailing address
1304 DUGWAY CT, WAKE FOREST, NC 27587-5535
(304) 640-2980
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
001522
WV
225700000X
Massage Therapist
Primary
2001-1648
WV
Other
Enumeration date
04/27/2011
Last updated
10/23/2015
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