Individual
CRYSTAL SMALLS-GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1310 SOUTHERN AVE SE, WASHINGTON, DC 20032-4699
(202) 574-6000
Mailing address
6534 CHRISTMAS TREE LN, HUNTINGTOWN, MD 20639-3211
(301) 787-8718
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA149
DC
Other
Enumeration date
05/10/2006
Last updated
10/05/2007
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