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Individual
MRS. CRYSTAL L WALTON
Active
Individual
MRS. CRYSTAL L WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C CNP
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0539
SD
208VP0014X
Interventional Pain Medicine Physician
0539
SD
363A00000X
Physician Assistant
0539
SD
Other
Enumeration date
10/25/2005
Last updated
01/10/2011
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