Mabry, Crystal B

Mabry, Crystal B is an sole proprietor health care provider with primary practice located at 15787 Coose Hollow Dr , Rogers AR 72756-8966. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Mabry, Crystal B can be contacted via phone (479) 925-3526.

Contact Information

Primary practice address
15787 Coose Hollow Dr Rogers AR 72756-8966
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X

Profile Details

NPI number 1881869238
LBN Legal business name Mabry, Crystal B
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 28th, 2008
Last updated Apr 28th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881869238 NPPES
Arkansas MEDICAID 153757783

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