Provider Demographics
NPI:1326620568
Name:CRYSTAL'S HEALING HANDS MASSAGE, LLC
Entity Type:Organization
Organization Name:CRYSTAL'S HEALING HANDS MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:STOOTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-776-2274
Mailing Address - Street 1:5771 PINE ACRES LN
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4727
Mailing Address - Country:US
Mailing Address - Phone:540-797-2274
Mailing Address - Fax:
Practice Address - Street 1:4600 BRAMBLETON AVE STE A
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3437
Practice Address - Country:US
Practice Address - Phone:540-776-2274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty