Individual
RICHARD W CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 POPLAR ST, SOUTH CHARLESTON, WV 25309-1474
(304) 342-3891
(304) 342-5307
Mailing address
500 POPLAR ST, SOUTH CHARLESTON, WV 25309-1474
(304) 342-3891
(304) 342-5307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00292
WV
Other
Enumeration date
08/24/2010
Last updated
11/01/2012
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