Individual
MARCIE CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 CHERRY BLOSSOM WAY, GEORGETOWN, KY 40324-9564
(502) 868-2000
Mailing address
320 LINDENHURST DR, APT 16101, LEXINGTON, KY 40509-1346
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1290
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1290
KENTUCKY BOARD OF MEDICAL LICENSURE
KY
Enumeration date
05/17/2016
Last updated
05/17/2016
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