MEDICARE: MS. JAMIE CRAWFORD LMT, MTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT043212	TX

General Provider Information

NPI Number	:	1306632823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAMIE CRAWFORD LMT, MTI

Provider Business Mailing Address
First Line	:	319 ADELL ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-2306
Country	:	US
Telephone Number	:	817-269-8051
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 ADELL ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-2306
Country	:	US
Telephone Number	:	817-269-8051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	04/21/2025

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