Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT30801 | FL |
NPI | 1073054888 |
---|---|
Provider Name | Leah Crawford |
First Address | Tampa, FL 33614-7100 |
Second Address | Tampa, FL 33614-7100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2017 |
Last Update Date | 13/03/2017 |