Individual
PAUL RICHARD MCCRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5546
(937) 257-1826
Mailing address
303 CREST HILL AVE, VANDALIA, OH 45377-1558
(937) 387-6970
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
TX
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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