MEDICARE: SEAN TODD-CROOKS

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1720467715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN TODD-CROOKS

Provider Business Mailing Address
First Line	:	3881 ERICA CIR
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30135-4117
Country	:	US
Telephone Number	:	678-653-2411
Fax Number	:	800-934-8987

Provider Business Practice Location Address
First Line	:	3881 ERICA CIR
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30135-4117
Country	:	US
Telephone Number	:	678-653-2411
Fax Number	:	800-934-8987

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

Provider Enumeration Date	:	05/22/2015
Last Update Date	:	05/22/2015

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Directions to “ SEAN TODD-CROOKS ” Practice Location

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