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General NPI Number Information
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NPI Number | 1225126782
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Entity Type | Individual
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Provider Name | JAMES R CREPS PT, DSCPT, OCS, CMPT
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 202 S LANE ST
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City | BLISSFIELD
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State | MI
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Zip | 49228-1243
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Country | US
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Telephone | 517-486-5278
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Fax | 517-486-5298
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Provider Business Mailing Address
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Address Line | 202 S LANE ST PO BOX 162
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City | BLISSFIELD
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State | MI
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Zip | 49228-1243
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Country | US
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Telephone | 517-486-5278
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Fax | 517-486-5298
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501002970
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License Number State | MI
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