Individual
MRS. CRYSTAL L FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-5276
(814) 274-4848
Mailing address
1001 E 2ND ST, COUDERSPORT, PA 16915-8161
(814) 274-5276
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA051431
PA
Other
Enumeration date
09/26/2006
Last updated
02/18/2022
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