Provider Demographics
NPI:1225744063
Name:CRYMES, ANDREW TYLER (MS, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:TYLER
Last Name:CRYMES
Suffix:
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SABLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-8902
Mailing Address - Country:US
Mailing Address - Phone:501-416-7117
Mailing Address - Fax:
Practice Address - Street 1:10 SCHOOL DR STE 225
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:AR
Practice Address - Zip Code:72058-9206
Practice Address - Country:US
Practice Address - Phone:501-679-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2651225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist