Individual
MR. DANIEL A CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
640 HANNINGS LN, MARTIN, TN 38237-3308
(731) 587-3193
(731) 588-2732
Mailing address
804 SUNSET DR, MADISONVILLE, KY 42431-1841
(270) 339-0355
(731) 588-2732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0000001524
TN
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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