Provider Demographics
NPI:1144232646
Name:CRANE, STEPHEN PAUL (PT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:PAUL
Last Name:CRANE
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 1:1135 W COOK RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3515
Mailing Address - Country:US
Mailing Address - Phone:419-756-2331
Mailing Address - Fax:419-756-3082
Practice Address - Street 1:1135 W COOK RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3515
Practice Address - Country:US
Practice Address - Phone:419-756-2331
Practice Address - Fax:419-756-3082
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT05144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist