| Doctor Name: | CRYSTAL N LACKEY |
| NPI Number: | 1255603486 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PT2939 |
| Business Practice Address: | 17706 I-30 Ste. 3 Benton, AR - 72019 |
| Business Phone Number: | 5013154414 |
| Business Fax Number: | 5017912094 |
| Mailing Address: | 17706 I-30, Ste. 3 BENTON |
| State: | AR |
| Postal Code: | 72019 |
| Phone Number: | 5013154414 |
| Fax Number: | 5017912094 |
| NPI Enumeration Date: | 02/03/2012 |
| NPI Last Update Date: | 04/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT2939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |