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Individual

MS. NANCY E CRAWFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
100 S GARRISON AVE, SAINT LOUIS, MO 63103-2538
(314) 340-5902
Mailing address
19 WILSHIRE TER, SAINT LOUIS, MO 63119-4603
(314) 968-8434

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
00779
MO
2251P0200X
Pediatric Physical Therapist
Primary
00779
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
483093738
MO
Enumeration date
02/22/2007
Last updated
05/19/2008
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