Individual
CARY LEE CROUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
838 BEACH CT., COLOMA, CA 95613
(530) 626-7252
(530) 626-7934
Mailing address
1813 POINT VIEW DR, PLACERVILLE, CA 95667-5008
(530) 409-4370
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9009
CAARR
CA
Enumeration date
09/23/2008
Last updated
09/23/2008
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