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Individual

MR. TERRY WAYNE CRAWFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPS

Contact information

Practice address
2801 INTERNATIONAL LN STE 205, MADISON, WI 53704-3152
(608) 241-4285
(608) 241-4286
Mailing address
2801 INTERNATIONAL LN STE 205, MADISON, WI 53704-3152
(608) 241-4285
(608) 241-4286

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
12418
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1700129376
WI
Enumeration date
08/24/2021
Last updated
02/24/2024
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