Individual
DESIREE CRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 VICTORIA HEIGHTS LN, DALLAS, GA 30132-9294
(336) 596-6882
Mailing address
222 VICTORIA HEIGHTS LN, DALLAS, GA 30132-9294
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN256140
GA
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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