Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5226 | MA |
N | 2251H1200X | Hand |
NPI | 1073704680 |
---|---|
Provider Name | Robert Crawford |
First Address | Westfield, MA 01085-1790 |
Second Address | Westfield, MA 01085-0000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 30/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9715568 | (05) | MA |