Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 1179 | OR |
NPI | 1124261961 |
---|---|
Provider Name | Dr. Crystal Lynn Urban |
First Address | Pulaski, WI 54162 |
Second Address | Pulaski, WI 54162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2009 |
Last Update Date | 24/10/2019 |