Individual
BRADEN G CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2225 N MAIN ST, MIAMI, OK 74354-1620
(918) 542-4101
(918) 542-4410
Mailing address
2225 N MAIN ST, MIAMI, OK 74354-1620
(918) 542-4101
(918) 542-4410
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3605
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3605
PTA LICENSURE
OK
Enumeration date
02/14/2023
Last updated
02/14/2023
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