Individual
MATTHEW CRISP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3252 E INDEPENDENCE ST, SPRINGFIELD, MO 65804
(888) 265-2680
Mailing address
9400 SAINT ANN DR, OKLAHOMA CITY, OK 73162-6400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1292928
TX
225100000X
Physical Therapist
Primary
2018037141
MO
225100000X
Physical Therapist
5427
OK
225100000X
Physical Therapist
PTH8877
AL
Other
Enumeration date
01/08/2018
Last updated
10/15/2018
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