MEDICARE: BRIAN CROWE DPT

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	225100000X	Physical Therapist	17492	MA
2	225100000X	Physical Therapist	2320	NE
3	225100000X	Physical Therapist	5658	AZ

General Provider Information

NPI Number	:	1336183441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN CROWE DPT

Provider Business Mailing Address
First Line	:	33 KNOLLWOOD CT
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-3820
Country	:	US
Telephone Number	:	508-721-0000
Fax Number	:	508-721-0100

Provider Business Practice Location Address
First Line	:	1 SAINT MARK ST
Second Line	:	SUITE B
City	:	AUBURN
State	:	MA
Zip	:	01501-3237
Country	:	US
Telephone Number	:	508-721-0000
Fax Number	:	508-721-0100

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	07/08/2007

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