Provider Demographics
NPI:1215216338
Name:HORTON, CRYSTAL ANNE (DPT)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:ANNE
Last Name:HORTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:CHRYS
Other - Middle Name:ANNE
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:8023 PSC
Mailing Address - Street 2:
Mailing Address - City:CHERRY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28533-8000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8023 PSC
Practice Address - Street 2:
Practice Address - City:CHERRY POINT
Practice Address - State:NC
Practice Address - Zip Code:28533-8000
Practice Address - Country:US
Practice Address - Phone:252-466-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist