Provider Demographics
NPI:1932904539
Name:CRAWFORD, LEE
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 E BETSY LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-9760
Mailing Address - Country:US
Mailing Address - Phone:480-395-7087
Mailing Address - Fax:
Practice Address - Street 1:949 E BETSY LN
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-9760
Practice Address - Country:US
Practice Address - Phone:480-395-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZG1A-8PV347C00000X
AZCSG9790347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle