Provider Demographics
NPI:1114147543
Name:CRUMPTON, JEFFERY MICHAEL (MSOTL)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:MICHAEL
Last Name:CRUMPTON
Suffix:
Gender:M
Credentials:MSOTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2834 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:AL
Mailing Address - Zip Code:35004-3436
Mailing Address - Country:US
Mailing Address - Phone:205-640-8956
Mailing Address - Fax:256-354-1294
Practice Address - Street 1:83825 HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:AL
Practice Address - Zip Code:36251
Practice Address - Country:US
Practice Address - Phone:256-354-1118
Practice Address - Fax:256-354-1294
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1863225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist