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General NPI Number Information
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NPI Number | 1831558147
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Entity Type | Individual
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Provider Name | GEORGE CROWLEY JR. PT
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Gender | Male
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 1365 CLINCY RD
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City | JACKSON
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State | MS
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Zip | 39213-9407
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Country | US
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Telephone | 662-820-6813
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Fax | 662-579-3327
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Provider Business Mailing Address
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Address Line | 1365 CLINCY RD
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City | JACKSON
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State | MS
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Zip | 39213-9407
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Country | US
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Telephone | 662-820-6813
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Fax | 662-579-3327
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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 | PT2744
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License Number State | MS
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