Provider Demographics
NPI:1376824185
Name:CROWLEY, DANIEL T (LMT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:T
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 581
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-0581
Mailing Address - Country:US
Mailing Address - Phone:207-431-8325
Mailing Address - Fax:207-474-8497
Practice Address - Street 1:22 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-2009
Practice Address - Country:US
Practice Address - Phone:207-431-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT3689173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist