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General NPI Number Information
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NPI Number | 1841521549
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Entity Type | Individual
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Provider Name | MADELINE CROSLEY RASMUSON P.T.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 998 W SEXTON RD
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City | SEBASTOPOL
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State | CA
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Zip | 95472-9131
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Country | US
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Telephone | 707-290-7991
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Fax | 707-928-7794
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Provider Business Mailing Address
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Address Line | 998 W SEXTON RD
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City | SEBASTOPOL
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State | CA
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Zip | 95472-9131
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Country | US
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Telephone | 707-290-7991
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Fax | 707-928-7794
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 15027
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License Number State | CA
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