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1619905478
STANLEY WAYNE CRADDOCK
CHARLOTTE, NC
NPI
1619905478
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NC 0086)
Enumeration Date
2006-06-29
Last Update Date
2007-07-08
Business Address
Mr. STANLEY WAYNE CRADDOCK LAT
7301 SARDIS RD
CHARLOTTE, NC 28270-6063
Phone number: 704-363-7147
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Mailing Address
Mr. STANLEY WAYNE CRADDOCK LAT
3208 RAVEN GLEN CT
CHARLOTTE, NC 28212-1509
Phone number: 704-576-7785
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