Individual
CRYSTAL LYNN SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9407 N GOVERNMENT WAY, SUITE 3, HAYDEN, ID 83835-7414
(208) 659-2296
Mailing address
9407 N. GOVERNMENT WAY, SUITE 3, HAYDEN, ID 83835-7414
(208) 659-2296
(208) 659-2296
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3615
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
455329257
MASSAGE THERAPY
ID
Enumeration date
11/07/2019
Last updated
06/08/2023
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