Individual
CRYSTAL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12506 NE 4TH AVE APT 101, NORTH MIAMI, FL 33161-4668
(305) 714-2159
Mailing address
12506 NE 4TH AVE APT 101, NORTH MIAMI, FL 33161-4668
(305) 714-2159
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA83036
FL
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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