Doctor Name: | MRS. STACIE LYNNE CROW |
NPI Number: | 1558687301 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NCTMB |
License Number: | 326624-00 |
Business Practice Address: | 6420 W Lake St St. Louis Park, MN - 55426 |
Business Phone Number: | 6512714963 |
Business Fax Number: | 9529266738 |
Mailing Address: | 3017 Florida Ave S, ST. LOUIS PARK |
State: | MN |
Postal Code: | 55426 |
Phone Number: | 6512714963 |
Fax Number: | 9529266738 |
NPI Enumeration Date: | 04/19/2010 |
NPI Last Update Date: | 04/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 326624-00 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |