Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1325891 | TX |
NPI | 1134788987 |
---|---|
Provider Name | Christine Crayton |
First Address | San Antonio, TX 78233-4681 |
Second Address | San Antonio, TX 78233-4681 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2019 |
Last Update Date | 06/11/2020 |