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NPI 1134227846

NPI 1134227846 : CRYSTAL MICHELLE TOMLINSON ATC, LAT : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1134227846
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    Entity Type          |    Individual 
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    Provider Name        |    CRYSTAL MICHELLE TOMLINSON ATC, LAT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    6201 SNEED CV APT. 821
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78744
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    Country              |    US
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    Telephone            |    832-643-2999
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6201 SNEED CV APT. 821
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78744-4274
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    Country              |    US
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    Telephone            |    832-643-2999
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    AT3669
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    License Number State |    TX
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