Provider Demographics
NPI:1972937225
Name:CROWE, ELIZABETH CLARE (PT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CLARE
Last Name:CROWE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13320 TEAKWOOD LN N
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:55327-9785
Mailing Address - Country:US
Mailing Address - Phone:651-353-8264
Mailing Address - Fax:
Practice Address - Street 1:8100 HIGHWOOD DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-1079
Practice Address - Country:US
Practice Address - Phone:952-831-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
9533OtherMN PT LICENSE