Individual
JERRY KOHOUT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2024 OLDE REGENT WAY STE 130, LELAND, NC 28451-4250
(910) 302-3330
(910) 213-3575
Mailing address
350 NEW FIDELITY CT, GARNER, NC 27529-2665
(570) 550-0168
(410) 648-4878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P22811
NC
225100000X
Physical Therapist
PT029822
PA
Other
Enumeration date
09/13/2021
Last updated
01/19/2024
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