Provider Demographics
NPI:1558687947
Name:CRAWFORD, JAMES L III (LMT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:CRAWFORD
Suffix:III
Gender:M
Credentials:LMT
Other - Prefix:MR
Other - First Name:JC
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:6821 COUNTY ROAD 51
Mailing Address - Street 2:
Mailing Address - City:SPENCERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46788-9704
Mailing Address - Country:US
Mailing Address - Phone:260-312-8921
Mailing Address - Fax:
Practice Address - Street 1:6821 COUNTY ROAD 51
Practice Address - Street 2:
Practice Address - City:SPENCERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46788-9704
Practice Address - Country:US
Practice Address - Phone:260-312-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-11
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT20901928111NR0400X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No111NR0400XChiropractic ProvidersChiropractorRehabilitation