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General NPI Number Information
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NPI Number | 1063236594
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Entity Type | Individual
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Provider Name | CHARLOTTE CRAWFORD LMT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1950 EASTWEST PKWY STE 117
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-6349
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Country | US
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Telephone | 904-999-7597
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Fax |
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Provider Business Mailing Address
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Address Line | 4001 ARBOR MILL CIR
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City | ORANGE PARK
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State | FL
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Zip | 32065-3216
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Country | US
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Telephone | 904-440-6909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 99896
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License Number State | FL
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