Healthcare Provider Details

I. General information

NPI: 1336627603
Provider Name (Legal Business Name): DEVIN CRAIG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 08/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8615 RIDGELYS CHOICE DR
NOTTINGHAM MD
21236-3026
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 410-529-3913
  • Fax: 410-313-8314
Mailing address:
  • Phone: 586-350-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT013825
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: