Individual
MRS. CRYSTAL LYNN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
775 SUNSET DR, ATHENS, GA 30606-2211
(706) 425-1543
Mailing address
935 LEM EDWARDS RD, WINTERVILLE, GA 30683-2021
(706) 255-1093
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002045
GA
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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