Provider Demographics
NPI:1417162009
Name:EMARD, CRYSTAL (DC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:EMARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41230 11TH ST W STE B
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1411
Mailing Address - Country:US
Mailing Address - Phone:661-949-1741
Mailing Address - Fax:661-485-7058
Practice Address - Street 1:41230 11TH ST W STE B
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1411
Practice Address - Country:US
Practice Address - Phone:661-949-1741
Practice Address - Fax:661-485-7058
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29655111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition