Individual
KIMBERLEY G CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
770 PINE ST, MACON, GA 31201-2173
(478) 633-1040
Mailing address
770 PINE ST, MACON, GA 31201-2173
(478) 633-1040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT000957
GA
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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