Individual
MRS. SUSANNE GRANER RAEDEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
207 FIELD ST, GREENVILLE, NC 27858
(252) 355-4908
Mailing address
207 FIELD ST, GREENVILLE, NC 27858
(252) 355-4908
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0123
NC
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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