Provider Demographics
NPI:1528412830
Name:TOLBERT, CRYSTAL GAIL (LMT)
Entity Type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:GAIL
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 SUNDOWN DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64054-1751
Mailing Address - Country:US
Mailing Address - Phone:816-306-5665
Mailing Address - Fax:
Practice Address - Street 1:4044 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2228
Practice Address - Country:US
Practice Address - Phone:816-786-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014012300225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist