Provider Demographics
NPI:1043685290
Name:CRYSTAL FARNSWORTH
Entity type:Organization
Organization Name:CRYSTAL FARNSWORTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FARNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:774-259-6751
Mailing Address - Street 1:205 E CENTRAL ST STE 7
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1364
Mailing Address - Country:US
Mailing Address - Phone:508-507-8015
Mailing Address - Fax:617-553-2603
Practice Address - Street 1:205 E CENTRAL ST STE 7
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1364
Practice Address - Country:US
Practice Address - Phone:508-507-8015
Practice Address - Fax:617-553-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261196171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty