Individual
JESSICA BAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
PT
Contact information
Practice address
3400 WAKE FOREST RD, RALEIGH, NC 27609-7317
(919) 681-2030
Mailing address
30100 FOLKLORE WAY, CARY, NC 27519-0919
(614) 315-4221
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/22/2025
Last updated
03/22/2025
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