Provider Demographics
NPI:1639555121
Name:CRAYMER, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CRAYMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8652 OLD CHANNEL TRL
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:MI
Mailing Address - Zip Code:49437-1365
Mailing Address - Country:US
Mailing Address - Phone:231-766-1000
Mailing Address - Fax:
Practice Address - Street 1:8652 OLD CHANNEL TRL
Practice Address - Street 2:
Practice Address - City:MONTAGUE
Practice Address - State:MI
Practice Address - Zip Code:49437-1365
Practice Address - Country:US
Practice Address - Phone:231-766-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL877081225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant