Individual
MS. CRYSTAL M JANUARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
18971 GREENFIELD RD, DETROIT, MI 48235-2908
(313) 837-4748
(313) 837-3772
Mailing address
18971 GREENFIELD RD., DETROIT, MI 48235
(313) 837-4748
(313) 837-3772
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193200000X
MULTI SPECIALTY GROUP
MI
01
—
225700000X
MASSAGE THERAPIST
MI
Enumeration date
11/06/2012
Last updated
11/06/2012
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