Individual
MRS. CRYSTAL KERSEY COTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
58 BIG A RD, TOCCOA, GA 30577
(706) 282-4200
(706) 886-8045
Mailing address
58 BIG A RD, TOCCOA, GA 30577-6017
(706) 282-4200
(706) 886-8045
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004427
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620119937C
—
GA
Enumeration date
08/14/2006
Last updated
08/26/2019
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