Individual
MRS. MAGGIE VENABLE PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6850 SILOAM RD, SILOAM, NC 27047-0032
(336) 374-2227
Mailing address
6850 SILOAM RD, SILOAM, NC 27047-6850
(336) 374-2227
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7319
NC
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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