Individual
DWAIN ELLIOT CRAWLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1223 GEORGIA ST, VALLEJO, CA 94590-6334
(707) 660-2192
Mailing address
1223 GEORGIA ST, VALLEJO, CA 94590-6334
(707) 660-2192
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
11716813
CA
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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