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General NPI Number Information
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NPI Number | 1275657462
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Entity Type | Individual
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Provider Name | PAUL ALAN CROUCH OTR
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Gender | Male
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 788 FOXLEY RD
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City | HOOD RIVER
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State | OR
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Zip | 97031-9722
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Country | US
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Telephone | 541-806-0047
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Fax | 541-386-3868
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Provider Business Mailing Address
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Address Line | 788 FOXLEY RD
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City | HOOD RIVER
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State | OR
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Zip | 97031-9722
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Country | US
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Telephone | 541-806-0047
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Fax | 541-386-3868
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1021091
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OT00002839
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License Number State | WA
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