Individual
JACKIE ELIZABETH HUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100 E RHODE ISLAND AVE, SOUTHERN PINES, NC 28387-4935
(910) 692-0371
(910) 692-0346
Mailing address
1307 IMBODEN DR, FRONT ROYAL, VA 22630-5343
(434) 996-4008
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602557
VA
Other
Enumeration date
06/03/2009
Last updated
11/03/2021
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