| NPI | 1215055645 |
|---|---|
| Former Name | CRYSTAL MARIE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 2331) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 33542) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2017-02-16 |