Healthcare Provider Details

I. General information

NPI: 1285641084
Provider Name (Legal Business Name): DAVID P CROWLEY LPT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24945 US HWY 19 N
CLEARWATER FL
33763
US

IV. Provider business mailing address

24945 US HIGHWAY 19 N
CLEARWATER FL
33763-3927
US

V. Phone/Fax

Practice location:
  • Phone: 727-726-1460
  • Fax: 727-724-9705
Mailing address:
  • Phone: 727-726-1460
  • Fax: 727-724-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9234
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT12249
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: