Individual
CRYSTAL WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
587 MAIN ST STE 126, NEW YORK MILLS, NY 13417-1491
(315) 281-7294
Mailing address
324 W EMBARGO ST, ROME, NY 13440-5036
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030625-1
NY
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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