Individual
JAMI GLYNN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
523 LYNCHBURG RD, PILOT MOUNTAIN, NC 27041-9326
(336) 408-0821
(336) 232-1411
Mailing address
5590 REYNOLDA RD, WINSTON SALEM, NC 27106-9694
(336) 922-0456
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4662
NC
225XP0200X
Pediatric Occupational Therapist
4662
NC
Other
Enumeration date
08/08/2008
Last updated
03/15/2018
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