Individual
JACLYN HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2611 SW 46TH AVE, AMARILLO, TX 79110-1735
(806) 355-6517
Mailing address
2611 SW 46TH AVE, AMARILLO, TX 79110-1735
(806) 355-6517
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2045680
TX
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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