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General NPI Number Information
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NPI Number | 1245587708
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Entity Type | Individual
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Provider Name | JONATHAN M CRAWFORD DPT
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Gender | Male
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 173 WASHINGTON ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-3789
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Country | US
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Telephone | 201-306-2532
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Fax |
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Provider Business Mailing Address
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Address Line | 1168 LAKE AVE APT 3
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City | CLARK
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State | NJ
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Zip | 07066-2745
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA1449300
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License Number State | NJ
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