Provider Demographics
NPI:1497834436
Name:CRANDALL, MARGARET ANN
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ANN
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 UNIVERSITY DR APT 7
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3966
Mailing Address - Country:US
Mailing Address - Phone:801-668-0128
Mailing Address - Fax:
Practice Address - Street 1:1144 UNIVERSITY DR APT 7
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3966
Practice Address - Country:US
Practice Address - Phone:801-668-0128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other