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Individual

MR. JUSTIN B CRAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
1000 FRIENDSHIP RD, TALLASSEE, AL 36078-1265
(334) 283-8032
(334) 283-1136
Mailing address
1000 FRIENDSHIP RD, TALLASSEE, AL 36078-1265
(334) 283-8032
(334) 283-1136

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
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