Individual
GRACE I CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13092-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13092-24
STATE LICENSE
WI
Enumeration date
06/23/2015
Last updated
11/29/2021
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