Provider Demographics
NPI:1316485774
Name:CRAWFORD, ALINA
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3179 S 9200 W
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-1615
Mailing Address - Country:US
Mailing Address - Phone:801-634-7695
Mailing Address - Fax:
Practice Address - Street 1:9115 W MAGNA MAIN ST
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044
Practice Address - Country:US
Practice Address - Phone:801-508-0880
Practice Address - Fax:801-508-0880
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT217581-11011744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management