Provider Demographics
NPI:1750631636
Name:CRANK, SALLY M
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:M
Last Name:CRANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5828 ALICE AVE
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-7212
Mailing Address - Country:US
Mailing Address - Phone:775-673-3853
Mailing Address - Fax:
Practice Address - Street 1:5828 ALICE AVE
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89433-7212
Practice Address - Country:US
Practice Address - Phone:775-673-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner