Provider Demographics
NPI:1245381193
Name:CRABB, KRISTI RENEE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:RENEE
Last Name:CRABB
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:492 JACK JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-3684
Mailing Address - Country:US
Mailing Address - Phone:478-374-1993
Mailing Address - Fax:229-868-2174
Practice Address - Street 1:113 EAST OAK STREET
Practice Address - Street 2:
Practice Address - City:MCRAE
Practice Address - State:GA
Practice Address - Zip Code:31055
Practice Address - Country:US
Practice Address - Phone:229-868-2174
Practice Address - Fax:229-868-2175
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1180225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant