Individual
CRYSTAL MARIE CARLILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
2080 HARRISON ST STE A, BATESVILLE, AR 72501-7447
(870) 709-2724
Mailing address
133 CARLILE ST, BATESVILLE, AR 72501-8828
(870) 844-5190
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 1880
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145178721
—
AR
01
—
5C243
BCBS
AR
Enumeration date
02/26/2007
Last updated
07/29/2024
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