Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | LAT-2525 | NC |
NPI | 1306204276 |
---|---|
Provider Name | Mrs. Valerie Pringle Jones |
First Address | Wilmington, NC 28403 |
Second Address | Wilmington, NC 28403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2016 |
Last Update Date | 05/02/2016 |