Wilson, Crystal Lavonne
Wilson, Crystal Lavonne is an individual health care provider with primary practice located at 702 N Main St , Harrison AR 72601-2900. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Wilson, Crystal Lavonne can be contacted via phone (870) 204-5330.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 4429 | Arkansas |
Profile Details
| NPI number | 1407414675 |
|---|---|
| LBN Legal business name | Wilson, Crystal Lavonne |
| Credentials | Physical Therapist Assistant (PTA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 3rd, 2019 |
| Last updated | Jun 3rd, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407414675 | NPPES |
| Arkansas | Other | 4429 | PTA LICENSE |
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