Individual
CHARSUEDE KEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
134 LYNNWOOD DR, BAINBRIDGE, GA 39819-6446
(229) 400-3735
(229) 400-3735
Mailing address
134 LYNNWOOD DR, BAINBRIDGE, GA 39819-6446
(229) 400-3735
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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