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NPI Code Detail

MEDICARE: CHRISTINE ELAINE CROWE PT, AT

MEDICARE: CHRISTINE ELAINE CROWE PT, AT
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
1225100000XPhysical Therapist8006SC

General Provider Information

NPI Number : 1609231281
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE ELAINE CROWE PT, AT
Provider Business Mailing Address
First Line : 4871 SOCASTEE BLVD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-7252
Country : US
Telephone Number : 843-293-5610
Fax Number : 843-293-5690
Provider Business Practice Location Address
First Line : 4871 SOCASTEE BLVD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-7252
Country : US
Telephone Number : 843-293-5610
Fax Number : 843-293-5690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2015
Last Update Date : 12/23/2015

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