Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 11-04635 | KS |
NPI | 1265820096 |
---|---|
Provider Name | Dr. Alicia Crowl |
First Address | Manhattan, KS 66502-4521 |
Second Address | Manhattan, KS 66502-4521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2015 |
Last Update Date | 01/01/2015 |