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Individual

MARILYN RAE CROWTHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
34852 363RD PL, ROCKY RIDGE AFC, AITKIN, MN 56431-5729
(218) 927-2755
Mailing address
34852 363RD PL, AITKIN, MN 56431-5729
(218) 927-2755

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1052834-1-AFC
MN

Other

Enumeration date
04/23/2010
Last updated
04/23/2010
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