Provider Demographics
NPI:1174904957
Name:CROMMETT, ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CROMMETT
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 1:384 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-6323
Mailing Address - Country:US
Mailing Address - Phone:781-246-2266
Mailing Address - Fax:781-246-1098
Practice Address - Street 1:384 LOWELL ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-6323
Practice Address - Country:US
Practice Address - Phone:781-246-2266
Practice Address - Fax:781-246-1098
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22077208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation