MEDICARE: CLINTON W CRAWLEY 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	PT012216	GA

General Provider Information

NPI Number	:	1821463084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLINTON W CRAWLEY PT, DPT

Provider Business Mailing Address
First Line	:	12 S LAKE DR
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31410-1727
Country	:	US
Telephone Number	:	912-446-5813
Fax Number	:	912-428-7146

Provider Business Practice Location Address
First Line	:	12 S LAKE DR
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31410-1727
Country	:	US
Telephone Number	:	912-446-5813
Fax Number	:	912-428-7146

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

Provider Enumeration Date	:	12/14/2015
Last Update Date	:	10/15/2025

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