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General NPI Number Information
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NPI Number | 1467463372
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Entity Type | Individual
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Provider Name | STEPHEN CROUSE RPT
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 1211 W LA PALMA AVE STE 506
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City | ANAHEIM
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State | CA
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Zip | 92801-2812
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Country | US
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Telephone | 714-491-3670
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Fax | 714-533-6760
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Provider Business Mailing Address
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Address Line | 1211 W LA PALMA AVE STE 506
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City | ANAHEIM
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State | CA
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Zip | 92801-2812
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Country | US
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Telephone | 714-491-3670
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Fax | 714-533-6760
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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 |
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License Number State |
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