Individual
CRYSTAL LEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
20 BALIN AVE, SOUTH SETAUKET, NY 11720-1122
(631) 388-9904
Mailing address
20 BALIN AVE, SOUTH SETAUKET, NY 11720-1122
(631) 901-9418
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
031236
NY
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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