Healthcare Provider Details

I. General information

NPI: 1417136946
Provider Name (Legal Business Name): MARGARET MARY CRUSE R.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 EASTERN AVE
BALTIMORE MD
21224-2115
US

IV. Provider business mailing address

809 N CHARLES ST
BALTIMORE MD
21201-5307
US

V. Phone/Fax

Practice location:
  • Phone: 410-284-1760
  • Fax: 410-284-1763
Mailing address:
  • Phone: 410-752-1532
  • Fax: 410-752-7025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number17673
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: