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General NPI Number Information
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NPI Number | 1578045076
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Entity Type | Individual
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Provider Name | LAUREN CRUTCHFIELD PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 1755 WITTINGTON PL STE 175
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City | DALLAS
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State | TX
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Zip | 75234-1905
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Country | US
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Telephone | 225-241-0329
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Fax |
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Provider Business Mailing Address
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Address Line | 8391 DAMA DR
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City | DENHAM SPRINGS
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State | LA
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Zip | 70706-1039
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Country | US
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Telephone | 225-241-0329
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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 | PTH8712
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License Number State | AL
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