Crystal Rose Dietrich, CMT is a
Massage Therapist based in Upsala, Minnesota. Crystal Rose Dietrich is licensed to practice in Minnesota (license number ) and her current practice location is
204 Borgstrom St, Upsala, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(320) 733-0153.
NPI number for Crystal Rose Dietrich is 1396194056 and her current mailing address is Po Box 152, Upsala, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1396194056.
Healthcare Provider's Profile
| Full Name | Crystal Rose Dietrich |
|---|
| Gender | Female |
|---|
| Speciality | Massage Therapist |
|---|
| Location | 204 Borgstrom St, Upsala, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1396194056
- Provider Enumeration Date: 06/03/2016
- Last Update Date: 07/21/2022
Medical Identifiers
Medical identifiers for Crystal Rose Dietrich such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396194056 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crystal Rose Dietrich is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Crystal Rose Dietrich, CMT
Po Box 152,
Upsala, MN 56384-0152
Ph: (320) 733-0153 | Crystal Rose Dietrich, CMT
204 Borgstrom St,
Upsala, MN 56384-4501
Ph: (320) 733-0153 |
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