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1013124775
GRACE ELAINE PUCKETT
MURRAY, KY
NPI
1013124775
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: KY A01203)
Enumeration Date
2007-05-16
Last Update Date
2007-07-08
Business Address
Mrs. GRACE ELAINE PUCKETT PTA
716 POPLAR ST
MURRAY, KY 42071-2546
Phone number: 270-762-1854
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Mailing Address
Mrs. GRACE ELAINE PUCKETT PTA
5163 AIRPORT RD
ALMO, KY 42020-9203
Phone number: 270-293-2610
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