Provider Demographics
NPI:1366644403
Name:CRANE, KATHRYN EVELYN (MSPT, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:EVELYN
Last Name:CRANE
Suffix:
Gender:F
Credentials:MSPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HAMILTON TER
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4324
Mailing Address - Country:US
Mailing Address - Phone:954-234-4783
Mailing Address - Fax:561-656-1806
Practice Address - Street 1:140 HAMILTON TER
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33414-4324
Practice Address - Country:US
Practice Address - Phone:954-234-4783
Practice Address - Fax:561-656-1806
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20108225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist