MEDICARE: MR. PATRICK ALFRED CREBBIN PT CHT

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	2754	OR
2	2251H1200X	Hand Physical Therapist	1021100611	CA

General Provider Information

NPI Number	:	1861460719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK ALFRED CREBBIN PT CHT

Provider Business Mailing Address
First Line	:	1929 VAN NESS AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601
Country	:	US
Telephone Number	:	541-882-2191
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 MOUNTAIN VIEW BLVD
Second Line	:	SUITE C
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601
Country	:	US
Telephone Number	:	541-883-3327
Fax Number	:	541-883-3175

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	09/11/2025

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