Individual
JACQUELINE CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
107 N HOYLE AVE, BAY MINETTE, AL 36507-4827
(251) 580-8236
(251) 580-8239
Mailing address
802 HAND AVE, BAY MINETTE, AL 36507-4511
(251) 580-8064
(251) 580-8239
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1913
AL
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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