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NPI Code Detail

MEDICARE: JOHN R CRUTCHFIELD BOCO, BOCP

MEDICARE: JOHN R CRUTCHFIELD BOCO, BOCP
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
1222Z00000XOrthotist
2224P00000XProsthetist

General Provider Information

NPI Number : 1902268956
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN R CRUTCHFIELD BOCO, BOCP
Provider Business Mailing Address
First Line : 2301 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4309
Country : US
Telephone Number : 336-333-9081
Fax Number :
Provider Business Practice Location Address
First Line : 2301 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4309
Country : US
Telephone Number : 336-333-9081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2016
Last Update Date : 03/29/2016

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