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General NPI Number Information
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NPI Number | 1407242886
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Entity Type | Individual
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Provider Name | SHELLEY CRANE LMT, NCTMB
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Gender | Female
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 34225 N 27TH DR STE 149
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City | PHOENIX
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State | AZ
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Zip | 85085-6087
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Country | US
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Telephone | 623-349-3212
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Fax |
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Provider Business Mailing Address
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Address Line | 317 W HONONEGH DR UNIT 1
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City | PHOENIX
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State | AZ
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Zip | 85027-3767
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Country | US
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Telephone | 623-349-3212
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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 | MT-09990
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License Number State | AZ
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