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General NPI Number Information
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NPI Number | 1770059909
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Entity Type | Individual
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Provider Name | AUSTIN CRAVEN PT, DPT, ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 74 RITTENHOUSE PL
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City | ARDMORE
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State | PA
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Zip | 19003-2227
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Country | US
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Telephone | 484-413-2973
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Fax |
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Provider Business Mailing Address
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Address Line | 800 LISBURN RD
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City | CARLISLE
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State | PA
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Zip | 17015-9230
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Country | US
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Telephone | 267-884-2266
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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 | PT5232
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT027329
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License Number State | PA
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