Individual
CRYSTAL MCKENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 SW 75TH ST APT E4, GAINESVILLE, FL 32607-6800
(352) 538-6612
Mailing address
501 SW 75TH ST APT E4, GAINESVILLE, FL 32607-6800
(352) 538-6612
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
FL
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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