Crystal Lynn Spencer, LMT
Massage Therapist in Hayden, ID. Individual provider (NPI-1).
NPI number1164067609
StatusActive
Last updated in NPPESJun 8, 2023
Details
- NPI
- 1164067609
- Entity type
- Individual (NPI-1)
- Name
- Crystal Lynn Spencer
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 7, 2019
- Certification date
- Jun 8, 2023
- Last updated
- Jun 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MAS-3615 | ID | Yes |
Practice location
9407 N Government WaySuite 3
Hayden, ID 83835-7414
Phone 208-659-2296
Mailing address
9407 N. Government WaySuite 3
Hayden, ID 83835-7414
Phone 208-659-2296 · Fax 208-659-2296
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