MEDICARE: HALEIGH CRIPE PT, 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	5501304349	MI

General Provider Information

NPI Number	:	1407712367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEIGH CRIPE PT, DPT

Provider Business Mailing Address
First Line	:	6400 W MAIN ST
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-9272
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 W MAIN ST
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-9272
Country	:	US
Telephone Number	:	269-372-1027
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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