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1104307701
NIANA HADDOCK
STATESBORO, GA
NPI
1104307701
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2018-08-22
Last Update Date
2018-08-22
Business Address
NIANA HADDOCK
1332 SOUTHERN DR
STATESBORO, GA 30460-0001
Phone number: 912-478-3646
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Mailing Address
NIANA HADDOCK
910 LIBERTY CHURCH RD
VIENNA, GA 31092-5106
Phone number: 229-591-5929
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