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NPI Code Detail

MEDICARE: MRS. BREANNA RENE CRAWFORD PT

MEDICARE:  MRS. BREANNA RENE CRAWFORD  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist6040OR

General Provider Information

NPI Number : 1437381514
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BREANNA RENE CRAWFORD PT
Provider Business Mailing Address
First Line : 1129 NE 12TH ST
Second Line :
City : BEND
State : OR
Zip : 97701-4413
Country : US
Telephone Number : 541-728-3559
Fax Number : 541-241-3903
Provider Business Practice Location Address
First Line : 1129 NE 12TH ST
Second Line :
City : BEND
State : OR
Zip : 97701-4413
Country : US
Telephone Number : 541-728-3559
Fax Number : 541-241-3903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2009
Last Update Date : 10/26/2020

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Directions to “ MRS. BREANNA RENE CRAWFORD PT” Practice Location

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