Individual
DR. BRANDEN RICHARD CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-9355
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-9355
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0016920
CO
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/03/2011
Last updated
08/06/2024
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