Individual
MR. JUSTIN B CRAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH4404
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11507998
CAQH
—
01
—
51531618
BLUE CROSS BLUE SHIELD
AL
01
—
7981728
AETNA
AL
01
—
Q57152
UPIN
AL
Enumeration date
06/21/2006
Last updated
07/08/2007
Update your record
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