Individual
MS. THERESA LYNN CROWDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
207 N AXTEL AVE, MILFORD, IL 60953-1003
(815) 889-4241
(815) 889-4244
Mailing address
309 S JAMES ST, GOODLAND, IN 47948-8124
(517) 425-9427
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601003575
MI
363A00000X
Physician Assistant
Primary
85002866
IL
Other
Enumeration date
09/02/2005
Last updated
07/08/2007
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