Provider Demographics
NPI:1962194225
Name:CRANE, ANDREA (DPT, PT)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:CRANE
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 STONEYBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-6409
Mailing Address - Country:US
Mailing Address - Phone:978-771-2056
Mailing Address - Fax:
Practice Address - Street 1:885 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1800
Practice Address - Country:US
Practice Address - Phone:978-851-8768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20969225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist