Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT008240L | PA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT008240L | PA |
NPI | 1013141720 |
---|---|
Provider Name | Elizabeth B Crockart |
First Address | Lancaster, PA 17603-2301 |
Second Address | Lancaster, PA 17603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 26/02/2019 |