Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2754 | OR |
N | 2251H1200X | Hand | 1021100611 | CA |
NPI | 1861460719 |
---|---|
Provider Name | Mr. Patrick Alfred Crebbin |
First Address | Klamath Falls, OR 97601 |
Second Address | Klamath Falls, OR 97601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 08/07/2007 |