MISS Crystallene Celestial Medlin, LMT

NPI #1962760165 in Longview, Washington

Provider Information

NPI Number: 1962760165
Entity Type: Individual
Name: MISS Crystallene Celestial Medlin, LMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: LMT
Enumeration Date: Apr 25, 2012
Last Updated: Apr 25, 2012

Practice Location

Address: 1146 COMMERCE AVE
City: Longview
State: Washington
ZIP Code: 98632-3025
Phone: (360) 577-6956

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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