Individual
MS. JANIQUE SHONTIA CRAFTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3926 LINDSEY DR, MACON, GA 31206-3941
(678) 608-6131
Mailing address
3926 LINDSEY DR, MACON, GA 31206-3941
(678) 608-6131
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
052358346
GA
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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