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1821406547
CRYSTAL LOOSE
WILLIAMSPORT, PA
NPI
1821406547
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: PA MA056962)
Enumeration Date
2014-07-25
Last Update Date
2021-05-24
Business Address
CRYSTAL LOOSE
1705 WARREN AVE SUITE 101103
WILLIAMSPORT, PA 17701-2647
Phone number: 570-321-2020
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Mailing Address
CRYSTAL LOOSE
1201 GRAMPIAN BLVD SUITE 101103
WILLIAMSPORT, PA 17701-1900
Phone number:
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