Provider Demographics
NPI:1972588101
Name:CROWELL, STEPHEN (MSPT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:CROWELL
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 OAK ST
Mailing Address - Street 2:REBOUND PHYSICAL THERAPY
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:203 OAK ST
Practice Address - Street 2:REBOUND PHYSICAL THERAPY
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1306
Practice Address - Country:US
Practice Address - Phone:508-651-0051
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA45429OtherHARVARD PILGRIM
MA1078212OtherAETNA
MA621300OtherTUFTS
MA8077207OtherCIGNA W/TUFTS LOGO
MA621300OtherTUFTS