Provider Demographics
NPI:1225209273
Name:PICKETT, ROWLAND NAROND (MPT)
Entity Type:Individual
Prefix:MR
First Name:ROWLAND
Middle Name:NAROND
Last Name:PICKETT
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:MR
Other - First Name:RON
Other - Middle Name:
Other - Last Name:PICKETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:5675 JUNEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4860
Mailing Address - Country:US
Mailing Address - Phone:910-273-2991
Mailing Address - Fax:910-679-0181
Practice Address - Street 1:5675 JUNEBERRY LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4860
Practice Address - Country:US
Practice Address - Phone:910-273-2991
Practice Address - Fax:910-679-0181
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9218225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist