Clark, Crystal Nichols

Clark, Crystal Nichols is an individual health care provider with primary practice located at 4968 Bethany Rd , Rustburg VA 24588-3693. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Clark, Crystal Nichols can be contacted via phone (434) 845-3554.

Contact Information

Primary practice address
4968 Bethany Rd Rustburg VA 24588-3693
Phone: (434) 845-3554
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2306001767 Virginia

Profile Details

NPI number 1104155480
LBN Legal business name Clark, Crystal Nichols
Credentials LPTA
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2009
Last updated Dec 15th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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