Individual
CHARLES CHRISTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 WAGNER RD, BONIFAY, FL 32425-2923
(706) 681-3684
Mailing address
92 BRADFORD ST APT 4, FORT WALTON BEACH, FL 32547-1943
(706) 681-3684
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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