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Individual
STEVEN G CRANDALL
Active
Individual
STEVEN G CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
118117-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11811724000001
BLUE CROSS BLUE SHIELD
UT
01
—
2738637001
CIGNA
UT
01
—
5417
DMBA
UT
01
—
6400624
UNITED HEALTHCARE
UT
01
—
65521
PEHP
UT
01
—
870388269BR1
EDUCATORS MUTUAL
UT
01
—
CJ9402
RAILROAD MEDICARE
UT
Enumeration date
08/03/2005
Last updated
01/04/2011
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