Provider Demographics
NPI:1609067206
Name:CRAWFORD, JULIE MARIE (LPTA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7667 SUTTONTOWN RD
Mailing Address - Street 2:
Mailing Address - City:FAISON
Mailing Address - State:NC
Mailing Address - Zip Code:28341-7265
Mailing Address - Country:US
Mailing Address - Phone:910-594-0864
Mailing Address - Fax:
Practice Address - Street 1:7667 SUTTONTOWN RD
Practice Address - Street 2:
Practice Address - City:FAISON
Practice Address - State:NC
Practice Address - Zip Code:28341-7265
Practice Address - Country:US
Practice Address - Phone:910-594-0864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3024225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant