Individual
NANETTE KAY MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
424 W JAMES LEE BLVD, CRESTVIEW, FL 32536-2638
(850) 689-2260
(850) 398-6211
Mailing address
424 W JAMES LEE BLVD, CRESTVIEW, FL 32536-2638
(850) 689-2260
(850) 398-6211
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
E0953
FL
247200000X
Other Technician
Primary
FS864804
FL
Other
Enumeration date
02/01/2010
Last updated
02/01/2010
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