Healthcare Provider Details

I. General information

NPI: 1063359073
Provider Name (Legal Business Name): CRYSTAL ADAMS OTR/L, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 US HIGHWAY 127 S STE A3
FRANKFORT KY
40601-4362
US

IV. Provider business mailing address

1141 RICHLIEV LN
FRANKFORT KY
40601-8482
US

V. Phone/Fax

Practice location:
  • Phone: 502-229-7372
  • Fax:
Mailing address:
  • Phone: 502-229-7372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number166970
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number244347
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: