| NPI | 1811289051 |
|---|---|
| Former Name | CRYSTAL NICOLE HOLLINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH8275) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 3362) |
| 225200000X Physical Therapy Assistant (Licence: TX 2081518) | |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2017-03-31 |