Individual
MS. CRYSTAL L PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15731 CIRCLEGREEN DR, CHARLOTTE, NC 28273-6985
(336) 671-9984
Mailing address
15731 CIRCLEGREEN DR, CHARLOTTE, NC 28273-6985
(336) 671-9984
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3264
NC
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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