Individual
CRYSCILLA MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8423 MARKET ST, STE 205, BOARDMAN, OH 44512-6778
(330) 729-1933
(330) 729-1861
Mailing address
8423 MARKET ST, STE 205, BOARDMAN, OH 44512-6778
(330) 729-1934
(330) 729-1861
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50004041
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119669
—
OH
Enumeration date
08/19/2014
Last updated
01/01/2017
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