Individual
CHARLES J CROAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
51600 HUNTINGTON RD, SUITE B, LAPINE, OR 97739-9626
(541) 536-7443
(541) 536-7805
Mailing address
805 SW INDUSTRIAL WAY, SUITE 3, BEND, OR 97702-1093
(541) 585-2529
(541) 585-2535
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2583
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158751
—
OR
Enumeration date
04/03/2007
Last updated
04/27/2010
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