Individual
MRS. CRYSTAL DAWN TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
300 OVERLOOK DR, PIKETON, OH 45661-9760
(740) 289-4074
Mailing address
5016 LUCASVILLE MINFORD RD, MINFORD, OH 45653-8770
(740) 820-3451
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA06411
OH
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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