Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1265086326 |
---|---|
Provider Name | Steven Crouchley |
First Address | Melbourne, FL 32940-6858 |
Second Address | Merritt Island, FL 32953-5034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2019 |
Last Update Date | 27/07/2019 |