Provider Demographics
NPI:1689067175
Name:CRAWFORD, CHRIS (MSE, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:MSE, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 E COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1851
Mailing Address - Country:US
Mailing Address - Phone:913-971-3694
Mailing Address - Fax:
Practice Address - Street 1:2030 E COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1851
Practice Address - Country:US
Practice Address - Phone:913-971-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-003562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer