Individual
SUSAN LUELLA CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
803 CRAIG AVE, SALEM, VA 24153-2839
(540) 793-7729
Mailing address
229 UNION ST, SALEM, VA 24153-4929
(540) 397-1355
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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