Crystal Deken

NPI #1235361692 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1235361692
Entity Type: Individual
Name: Crystal Deken
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Aug 19, 2009
Last Updated: Aug 19, 2009

Practice Location

Address: 3001 WARRIOR LN
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-8685
Phone: (573) 686-1200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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