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1720117526
ARCHIE CROCKER
KINGS MOUNTAIN, NC
NPI
1720117526
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
310400000X Assisted Living Facility
(Licence: NC FCL 023-010)
Enumeration Date
2007-03-05
Last Update Date
2007-07-09
Business Address
-- ARCHIE CROCKER
429 CROCKER RD
KINGS MOUNTAIN, NC 28086-4004
Phone number: 704-739-6429
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Mailing Address
-- ARCHIE CROCKER
102 COUNTRY CREEK DR
KINGS MOUNTAIN, NC 28086-8903
Phone number:
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