Individual
JESSICA CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7600 ANTIOCH RD, OVERLAND PARK, KS 66204-2622
(913) 383-2001
Mailing address
501 SE ASHEVILLE DR, LEES SUMMIT, MO 64063-1066
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02950
KS
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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