Individual
MRS. JENNIFER M MADDOCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
3701 NW CARY PARKWAY, SUITE 301, CARY, NC 27513
(919) 388-0111
(919) 388-8668
Mailing address
3701 NW CARY PARKWAY, SUITE 301, CARY, NC 27513
(919) 388-0111
(919) 388-8668
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8277
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079C2
BCBS
NC
01
—
3210671
AETNA HMO
NC
01
—
5004734
AETNA PPO
NC
01
—
6698131
GHI
NC
01
—
7360555
UHC ACN MPN
NC
01
—
836264
UHC ACN MPN
NC
Enumeration date
08/01/2006
Last updated
07/08/2007
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