Individual
MRS. CRYSTAL DAWN WALTOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
403 E FLOURNOY LUCAS RD, SHREVEPORT, LA 71115-3906
(318) 798-3500
Mailing address
150 GLADNEY FARM RD, HOMER, LA 71040-5009
(337) 427-0160
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
200690
LA
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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