Individual
JERRY AUSTIN CRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2981 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
(573) 712-2902
Mailing address
2981 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
(573) 712-2902
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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