MR. Kenneth Craig Stallings, L..O.

NPI #1205900909 in Blue Ridge, Georgia

Provider Information

NPI Number: 1205900909
Entity Type: Individual
Name: MR. Kenneth Craig Stallings, L..O.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: L..O.
Enumeration Date: Nov 17, 2006
Last Updated: Feb 15, 2013

Practice Location

Address: 5801 BLUE RIDGE DR
City: Blue Ridge
State: Georgia
ZIP Code: 30513-3245
Phone: (706) 632-0384

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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