Individual
JACQUELINE ADDISON WALDROP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4312 WHIPPORWILL LN, METROPOLIS, IL 62960-3906
(270) 331-3998
Mailing address
4312 WHIPPORWILL LN, METROPOLIS, IL 62960-3906
(270) 331-3998
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A04551
KY
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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