Individual
MRS. WANDA LISA CRUNKLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1705 TARBORO ST SW, WILSON, NC 27893-3428
(252) 399-8998
Mailing address
274 WATERY BRANCH CHURCH RD, STANTONSBURG, NC 27883-9179
(919) 920-3850
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
604
NC
Other
Enumeration date
09/08/2018
Last updated
09/08/2018
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