Provider Demographics
NPI:1710634779
Name:CRAWFORD, ABIGAIL (DPT, PT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:8912 BLAKENEY PROFESSIONAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6735
Mailing Address - Country:US
Mailing Address - Phone:704-544-5353
Mailing Address - Fax:
Practice Address - Street 1:8912 BLAKENEY PROFESSIONAL DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6735
Practice Address - Country:US
Practice Address - Phone:704-544-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP210272081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine