Individual
GWEN CRADDOCK I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5942 WILSON DR, HUNTINGTON, WV 25705-2637
(304) 733-6497
(304) 733-6498
Mailing address
5942 WILSON DR, HUNTINGTON, WV 25705-2637
(304) 733-6497
(304) 733-6498
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OH
Other
Enumeration date
04/24/2007
Last updated
07/26/2007
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