Individual
KRYSTYN RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 226-8881
(229) 584-5964
Mailing address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 226-8881
(229) 584-5964
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002270
IA
Other
Enumeration date
03/21/2012
Last updated
09/09/2020
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