Provider Demographics
NPI:1831852094
Name:HUNTER, CRYSTAL LEIGH (LMT)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LEIGH
Last Name:HUNTER
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 1:39248 US HIGHWAY 19 N LOT 345
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-7909
Mailing Address - Country:US
Mailing Address - Phone:813-263-0655
Mailing Address - Fax:727-221-9489
Practice Address - Street 1:39248 US HIGHWAY 19 N LOT 345
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-7909
Practice Address - Country:US
Practice Address - Phone:813-263-0655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA81137225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist