Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3223 | NE |
NPI | 1003253790 |
---|---|
Provider Name | Lindsey Marie Crook |
First Address | David City, NE 68632-0211 |
Second Address | North Bend, NE 68649-4430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 14/10/2013 |