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Individual

MR. CRAIG EDWARD MADDOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
46 NICHOLS ST, RUTLAND, VT 05701-3275
(802) 775-2941
Mailing address
21 WOODSWORTH CLOSE, RED DEER, ALBERTA T4N 5-L9
(530) 320-9864

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
072.0078254
VT

Other

Enumeration date
06/15/2011
Last updated
06/15/2011
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