MEDICARE: MR. STEPHEN WILSON CRAPPS MSPT, STC

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
1	225100000X	Physical Therapist	5022	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00267657	OTHER		RAILROAD MEDICARE
3	P00685515	OTHER		RAILROAD MEDICARE
4	P00267657	OTHER	SC	RAILROAD MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	187188	OTHER	SC	MEDCOST PROVIDER NUMBER

General Provider Information

NPI Number	:	1710921010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN WILSON CRAPPS MSPT, STC

Provider Business Mailing Address
First Line	:	4 OKATIE CENTER BLVD. S
Second Line	:
City	:	OKATIE
State	:	SC
Zip	:	29909-7530
Country	:	US
Telephone Number	:	843-705-9480
Fax Number	:	843-705-9481

Provider Business Practice Location Address
First Line	:	4 OKATIE CENTER BLVD. S
Second Line	:	SUITE 101
City	:	OKATIE
State	:	SC
Zip	:	29909-7530
Country	:	US
Telephone Number	:	843-705-9480
Fax Number	:	843-705-9481

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	08/08/2022

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Directions to “ MR. STEPHEN WILSON CRAPPS MSPT, STC” Practice Location

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