Individual
CRYSTAL MARIE MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
401 HAZLE TOWNSHIP BLVD, HAZLE TOWNSHIP, PA 18202-9661
(570) 454-8888
Mailing address
75 SAND SPRING RD, WEATHERLY, PA 18255-3801
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI002563
PA
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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