Individual
CRYSTAL WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1263 ODELL LN, GREENWOOD, IN 46143-7966
(317) 794-6979
Mailing address
1263 ODELL LN, GREENWOOD, IN 46143-7966
(317) 794-6979
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
300079808
IN
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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