Individual
JACKSON RAY FAUGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2427 TRYON RD, DURHAM, NC 27705-5511
(919) 452-7915
Mailing address
2427 TRYON RD, DURHAM, NC 27705-5511
(919) 452-7915
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P19522
NC
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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