Individual
MARY ELLEN HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFTS
Contact information
Practice address
131 THIRD STREET, AYDEN, NC 28513-7252
(252) 746-3492
(252) 746-4838
Mailing address
131 THIRD STREET, AYDEN, NC 28513-7252
(252) 746-3492
(252) 746-4838
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
CFTS1166
NC
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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