Provider Demographics
NPI:1013356831
Name:CRANDALL, STEVE (PT)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:
Last Name:CRANDALL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W BERRYHILL DR
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5835
Mailing Address - Country:US
Mailing Address - Phone:530-205-9538
Mailing Address - Fax:530-460-1841
Practice Address - Street 1:130 W BERRYHILL DR
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5835
Practice Address - Country:US
Practice Address - Phone:530-205-9538
Practice Address - Fax:530-460-1841
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 27297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist