Individual
KENNETH PATRICK CRAIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1049 E COLTER ST, PHOENIX, AZ 85014-2672
(928) 284-8276
Mailing address
1049 E COLTER ST, PHOENIX, AZ 85014-2672
(928) 284-8276
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
278658
AZ
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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