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Organization
BRENT CRANE MD LLC
Active
Organization
BRENT CRANE MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT A CRANE MD (OWNER)
(937) 367-6496
Entity
Organization
Contact information
Practice address
200 N MAIN ST, HAVILAND, KS 67059-9525
(937) 367-6496
Mailing address
1324 WOODSTOCK DR, OAKWOOD, OH 45419-3033
(937) 367-6496
(316) 687-0328
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
KA4287013
—
KS
Enumeration date
04/17/2020
Last updated
07/13/2021
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