| NPI | 1003224072 |
|---|---|
| Former Name | CRYSTAL SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1245138) |
| 225100000X Physical Therapist (Licence: TN 10057) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2021-07-01 |