Provider Demographics
NPI:1639881618
Name:CRABTREE, THOMAS HORTON JR (ATC, LAT, LPTA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:HORTON
Last Name:CRABTREE
Suffix:JR
Gender:M
Credentials:ATC, LAT, LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 CONLEY RD
Mailing Address - Street 2:
Mailing Address - City:MC DERMOTT
Mailing Address - State:OH
Mailing Address - Zip Code:45652-9060
Mailing Address - Country:US
Mailing Address - Phone:740-357-3707
Mailing Address - Fax:
Practice Address - Street 1:471 CONLEY RD
Practice Address - Street 2:
Practice Address - City:MC DERMOTT
Practice Address - State:OH
Practice Address - Zip Code:45652-9060
Practice Address - Country:US
Practice Address - Phone:740-357-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA007198225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty