Provider Demographics
NPI:1174881163
Name:CRAWFORD, KATHERINE PAIGE (DPT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:PAIGE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9970 CENTRAL PARK BLVD N
Mailing Address - Street 2:SUITE 300-B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2231
Mailing Address - Country:US
Mailing Address - Phone:561-487-7874
Mailing Address - Fax:561-487-7884
Practice Address - Street 1:9970 CENTRAL PARK BLVD N
Practice Address - Street 2:SUITE 300-B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2231
Practice Address - Country:US
Practice Address - Phone:561-487-7874
Practice Address - Fax:561-487-7884
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT25993OtherPT LICENSE