Individual
CRYSTAL FENNESSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3045 N FEDERAL HWY STE 60H, FORT LAUDERDALE, FL 33306-1415
(954) 567-8011
Mailing address
3045 N FEDERAL HWY STE 60H, FORT LAUDERDALE, FL 33306-1415
(954) 567-8011
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA56026
FL
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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