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NPI Code Detail

MEDICARE: MS. CRYSTAL JOHNSON LMT

MEDICARE: MS. CRYSTAL JOHNSON LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistLA5345LA

General Provider Information

NPI Number : 1063381994
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CRYSTAL JOHNSON LMT
Provider Business Mailing Address
First Line : 318 BERTRAND DR # 101
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-5636
Country : US
Telephone Number : 337-889-5820
Fax Number : 337-889-5821
Provider Business Practice Location Address
First Line : 318 BERTRAND DR # 101
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-5636
Country : US
Telephone Number : 337-889-5820
Fax Number : 337-889-5821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2025
Last Update Date : 10/30/2025

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Directions to “ MS. CRYSTAL JOHNSON LMT” Practice Location

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