Provider Demographics
NPI:1346860343
Name:HELMEID, CRYSTAL D (LMBT)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:D
Last Name:HELMEID
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 LIME ROCK RD
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27011-8133
Mailing Address - Country:US
Mailing Address - Phone:608-449-3424
Mailing Address - Fax:
Practice Address - Street 1:2427 SMITHTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST BEND
Practice Address - State:NC
Practice Address - Zip Code:27018-8239
Practice Address - Country:US
Practice Address - Phone:608-449-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14918225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14918OtherNORTH CAROLINA BOARD OF MASSAGE & BODYWORK THERAPY