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General NPI Number Information
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NPI Number | 1952508384
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Entity Type | Individual
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Provider Name | CRYSTAL MONIC SOLIZ LMT, CMMT
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 204 N AUSTIN AVE
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City | LAMESA
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State | TX
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Zip | 79331-5430
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Country | US
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Telephone | 806-872-2516
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Fax |
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Provider Business Mailing Address
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Address Line | 1906 N 13TH ST
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City | LAMESA
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State | TX
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Zip | 79331-2804
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Country | US
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Telephone | 806-891-8886
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT045893
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License Number State | TX
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