Provider Demographics
NPI:1699866699
Name:CROWLEY, JAROD HEATH (ATC, CSCS)
Entity type:Individual
Prefix:
First Name:JAROD
Middle Name:HEATH
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 N 2ND ST
Mailing Address - Street 2:MOTHER TERESA CENTER RM 103
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-1402
Mailing Address - Country:US
Mailing Address - Phone:913-360-7378
Mailing Address - Fax:913-360-7650
Practice Address - Street 1:1020 N 2ND ST
Practice Address - Street 2:MOTHER TERESA CENTER RM 103
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-1402
Practice Address - Country:US
Practice Address - Phone:913-360-7378
Practice Address - Fax:913-360-7650
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-003452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer