MEDICARE: MS. ELIZABETH CLARE CROWE 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	9533	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9533	OTHER		MN PT LICENSE

General Provider Information

NPI Number	:	1972937225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH CLARE CROWE PT

Provider Business Mailing Address
First Line	:	13320 TEAKWOOD LN N
Second Line	:
City	:	DAYTON
State	:	MN
Zip	:	55327-9785
Country	:	US
Telephone Number	:	651-353-8264
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 HIGHWOOD DR
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1079
Country	:	US
Telephone Number	:	952-831-7500
Fax Number	:

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

Provider Enumeration Date	:	08/22/2013
Last Update Date	:	09/27/2021

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