Provider Demographics
NPI:1427800663
Name:CRAWFORD, MARK E (PTA)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5901 US HIGHWAY 27 S STE 10
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2117
Mailing Address - Country:US
Mailing Address - Phone:863-314-9991
Mailing Address - Fax:863-314-0057
Practice Address - Street 1:5901 US HIGHWAY 27 S STE 10
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2117
Practice Address - Country:US
Practice Address - Phone:863-314-9991
Practice Address - Fax:863-314-0057
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA15840225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant