Individual
MRS. SANDRA GAIL CROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
412 E FAULKNER ST, EL DORADO, AR 71730-5802
(870) 881-4677
Mailing address
1207 W BLOCK ST, EL DORADO, AR 71730-5355
(870) 864-3959
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
PTA 1862
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145351721
—
AR
Enumeration date
04/01/2009
Last updated
03/18/2010
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