Individual
CRYSTAL NMN CHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3451 JOHN WILLIAMS RD, CONNELLYS SPRINGS, NC 28612-7338
(828) 448-4195
Mailing address
111 N MERGANSER DR, PIKEVILLE, NC 27863-8117
(828) 448-4195
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22066
NC
390200000X
Student in an Organized Health Care Education/Training Program
3902000000X
NC
Other
Enumeration date
11/24/2008
Last updated
05/20/2017
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