JACKIE WILMOTH

WINSTON SALEM, NC
NPI1255679155
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: NC  A4893)
Enumeration Date2013-01-28
Last Update Date2013-01-28
Business Address
-- JACKIE WILMOTH
849 WATERWORKS RD
WINSTON SALEM, NC 27101-1956
Phone number: 336-595-2166
Mailing Address
-- JACKIE WILMOTH
100 KERNEY TRL
THURMOND, NC 28683-9571
Phone number:
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