Provider Demographics
NPI:1245690684
Name:OHNMEISS, CRYSTAL (LMT)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:OHNMEISS
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 1:1923 SENECA ST
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14210-1852
Mailing Address - Country:US
Mailing Address - Phone:716-253-1561
Mailing Address - Fax:716-931-9470
Practice Address - Street 1:1923 SENECA ST
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-1852
Practice Address - Country:US
Practice Address - Phone:716-253-1561
Practice Address - Fax:716-931-9470
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-27
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028813225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist