Individual
CHARLO BRANDON CRUMPACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1424 MOLALLA AVE, OREGON CITY, OR 97045-4004
(503) 744-4916
Mailing address
1200 CORPORATE DR, HOOVER, AL 35242-2941
(423) 682-8840
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
63405
OR
Other
Enumeration date
08/08/2019
Last updated
03/09/2021
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