Individual
DERRICK ANTONIA CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
12856 DEAUVILLE DR, OMAHA, NE 68137-3204
(402) 895-2266
(402) 895-2840
Mailing address
2107 DOVER CT, BELLEVUE, NE 68005-4366
(402) 895-2266
(402) 895-2840
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
481
NE
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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