Healthcare Provider Details

I. General information

NPI: 1972907467
Provider Name (Legal Business Name): CRYSTAL HORKANS L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 GRAYS FERRY AVE
PHILADELPHIA PA
19146-1177
US

IV. Provider business mailing address

3601 MERRICK RD
PHILADELPHIA PA
19129-1614
US

V. Phone/Fax

Practice location:
  • Phone: 215-772-0770
  • Fax:
Mailing address:
  • Phone: 614-218-9642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000279
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: