Individual
SUSAN DIANNE CHEATWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1701 PELHAM RD S STE B, JACKSONVILLE, AL 36265-3372
(256) 782-4256
(256) 782-4242
Mailing address
713 OAK ST, ANNISTON, AL 36207-4766
(256) 591-5873
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2039828
AL
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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