Most Relevant Information
Provider Data
| NPI Number: | 1003439985 |
| Provider Name: | SHELBY ANGELA CRANDALL EMT |
| Entity Type: | Individual |
| Taxonomy Code: | 146N00000X |
| Specialty: | Emergency Medical Technician, Basic |
| License Number: | 58590 |
Most Important Dates
| Enumeration Date: | 05/26/2020 |
| Last Updated: | 05/26/2020 |
Provider Practice Location
11 TWO SPRINGS RD
ENNIS
MT
597299188
Practice Location Phone/Fax
| Phone: | 4062105629 |
| Fax: |
Provider Mailing Location
11 TWO SPRINGS RD
ENNIS
MT
597299188
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |