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Individual

CRYSTAL FACKELMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1 BARRINGER DR, HAMLIN, NY 14464-9303
(585) 369-4145
Mailing address
1 BARRINGER DR, HAMLIN, NY 14464-9303
(585) 369-4145

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296090
NY

Other

Enumeration date
04/22/2016
Last updated
04/22/2016
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