Crystal Ward, L.M.T

Individual provider Active NPI Massage Therapist · Gainesboro, TN

NPI 1376907832 · NPPES record last updated Apr 11, 2016

Key facts

NPI
1376907832
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
0000008866 (TN)
Practice address
3314 Granville Hwy
Gainesboro, TN 38562-6182
Phone
(931) 268-7229
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0000008866TNMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 0000008866 TN Yes

Addresses

Primary practice location

3314 Granville Hwy
Gainesboro, TN 38562-6182

Mailing address

3314 Granville Hwy
Gainesboro, TN 38562-6182
Phone (931) 268-7229

Other identifiers

IdentifierTypeStateIssuer
0000008866OtherTNTENNESSEE MASSAGE LICENSURE BOARD

Other providers in Gainesboro, TN

All providers in Gainesboro, TN · Massage Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.