Individual
BENJAMIN CRAWLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1038 WILDER CHAPEL LN, MARYVILLE, TN 37804-3786
(865) 214-7712
Mailing address
1038 WILDER CHAPEL LN, MARYVILLE, TN 37804-3786
(865) 214-7712
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1000000018774
TN
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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