Provider Demographics
NPI:1568578375
Name:CRILL, JOSHUA J (CMT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:J
Last Name:CRILL
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 BOISE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4295
Mailing Address - Country:US
Mailing Address - Phone:970-663-6501
Mailing Address - Fax:
Practice Address - Street 1:1931 BOISE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4295
Practice Address - Country:US
Practice Address - Phone:970-663-6501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist