Provider Demographics
NPI:1215055645
Name:ROBBINS, CRYSTAL MARIE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MARIE
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:604 W WASHINGTON ST
Mailing Address - Street 2:STE B
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3828
Mailing Address - Country:US
Mailing Address - Phone:775-882-5001
Mailing Address - Fax:775-882-5015
Practice Address - Street 1:604 W WASHINGTON ST
Practice Address - Street 2:STE B
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3828
Practice Address - Country:US
Practice Address - Phone:702-737-8820
Practice Address - Fax:702-737-1622
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33542225100000X
NV2331225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBZ011YMedicare PIN