MEDICARE: CHERYL CRONK PT

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	PT9600	CA

General Provider Information

NPI Number	:	1851376933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL CRONK PT

Provider Business Mailing Address
First Line	:	2000 GARDEN RD
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5313
Country	:	US
Telephone Number	:	831-375-1885
Fax Number	:	831-375-7436

Provider Business Practice Location Address
First Line	:	1306 W AVENUE J
Second Line	:	STE 2
City	:	LANCASTER
State	:	CA
Zip	:	93534-2936
Country	:	US
Telephone Number	:	661-948-0186
Fax Number	:	661-945-5736

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	08/11/2011

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