Individual
KRYSTAL LEA MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 W STEWART AVE UNIT 1, MEDFORD, OR 97501-4705
(541) 261-8061
Mailing address
747 NE 12TH ST, GRANTS PASS, OR 97526-1659
(541) 415-9504
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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