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Individual

TYSON CARTER CRISMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
102 MEDICAL CENTER DR STE G, PRATTVILLE, AL 36066-7286
(334) 239-0708
(334) 440-8233
Mailing address
302 TAPIA LN, PRATTVILLE, AL 36067-6992
(334) 546-8822

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH4381
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTH4381
LICENSE #
AL
Enumeration date
08/29/2006
Last updated
06/03/2024
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