Basic Information
| Provider Information | |||||||||
| NPI: | 1124662697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COTHRAN | ||||||||
| FirstName: | CRYSTAL | ||||||||
| MiddleName: | DAWN | ||||||||
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| Credential: | RT R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 76 THOMPSON RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288069553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287080473 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 TUNNEL RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288052576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282987911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2019 | ||||||||
| LastUpdateDate: | 10/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471C3402X | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Radiography |
No ID Information.