Individual
SAMANTHA CRELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
2365 W CENTRAL, EL DORADO, KS 67042-3208
(316) 322-0253
(316) 322-7000
Mailing address
520 E AUGUSTA AVE, AUGUSTA, KS 67010-2100
(316) 322-0253
(316) 322-7000
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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