Provider Demographics
NPI:1104096023
Name:CRUTCHER, TIFFANY T (DPT)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:T
Last Name:CRUTCHER
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 1:745 SOUTHERN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:36089-6643
Mailing Address - Country:US
Mailing Address - Phone:334-738-5590
Mailing Address - Fax:334-738-2460
Practice Address - Street 1:745 SOUTHERN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:UNION SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:36089-6643
Practice Address - Country:US
Practice Address - Phone:334-738-5590
Practice Address - Fax:334-738-2460
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist