MEDICARE: KRYSTAL D ABRAHAMSEN

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
1	225700000X	Massage Therapist	MT124348	TX

General Provider Information

NPI Number	:	1558938688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTAL D ABRAHAMSEN

Provider Business Mailing Address
First Line	:	3700 PRESTON RD APT 1632
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7438
Country	:	US
Telephone Number	:	972-330-6636
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 PRESTON RD APT 1632
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7438
Country	:	US
Telephone Number	:	972-330-6636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	06/08/2021

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Directions to “ KRYSTAL D ABRAHAMSEN ” Practice Location

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