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General NPI Number Information
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NPI Number | 1770319154
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Entity Type | Individual
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Provider Name | SHELBY LYNN CRANE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2024
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 12201 HIGHWAY 92 STE C
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City | WOODSTOCK
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State | GA
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Zip | 30188-7141
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Country | US
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Telephone | 470-632-8335
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Fax |
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Provider Business Mailing Address
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Address Line | 735 MARKET ST UNIT 1109
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City | WOODSTOCK
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State | GA
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Zip | 30188-1736
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Country | US
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Telephone | 706-255-7400
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT017395
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License Number State | GA
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