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General NPI Number Information
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NPI Number | 1588905368
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Entity Type | Individual
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Provider Name | NOAH WILSON CROWTHER DPT
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Gender | Male
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 27789 MOUND RD STE 300
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City | WARREN
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State | MI
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Zip | 48092-2697
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Country | US
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Telephone | 586-203-9888
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Fax | 586-580-9948
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Provider Business Mailing Address
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Address Line | 17425 MACARTHUR
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City | REDFORD
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State | MI
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Zip | 48240-2242
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Country | US
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Telephone | 313-418-2489
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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 | 5501016179
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License Number State | MI
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