Provider Demographics
NPI:1710921010
Name:CRAPPS, STEPHEN WILSON (MSPT, STC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WILSON
Last Name:CRAPPS
Suffix:
Gender:M
Credentials:MSPT, STC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OKATIE CENTER BLVD. S
Mailing Address - Street 2:
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7530
Mailing Address - Country:US
Mailing Address - Phone:843-705-9480
Mailing Address - Fax:843-705-9481
Practice Address - Street 1:4 OKATIE CENTER BLVD. S
Practice Address - Street 2:SUITE 101
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909-7530
Practice Address - Country:US
Practice Address - Phone:843-705-9480
Practice Address - Fax:843-705-9481
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5022225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00267657OtherRAILROAD MEDICARE
SC187188OtherMEDCOST PROVIDER NUMBER
P00685515OtherRAILROAD MEDICARE
SCP00267657OtherRAILROAD MEDICARE NUMBER
P00267657OtherRAILROAD MEDICARE
P00685515OtherRAILROAD MEDICARE
SCQ338437620Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER