Basic Information
| Provider Information | |||||||||
| NPI: | 1033407424 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROWLEY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | PETER | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 137 GAY HILL RD | ||||||||
| Address2: | |||||||||
| City: | UNCASVILLE | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063822081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608483803 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 CONNECTICUT AVE | ||||||||
| Address2: | |||||||||
| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 063601502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608595100 | ||||||||
| FaxNumber: | 8608595110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2011 | ||||||||
| LastUpdateDate: | 07/19/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 9156 | CT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.