Individual
TABATHA CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 LAURENS RD STE J, GREENVILLE, SC 29607-2364
(864) 605-7002
(864) 605-7002
Mailing address
1401 LAURENS RD STE J, GREENVILLE, SC 29607-2364
(864) 605-7002
(864) 605-7002
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
28148
SC
Other
Enumeration date
08/23/2017
Last updated
07/21/2022
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