Provider Demographics
NPI:1790173516
Name:CROY, HOWARD NELSON JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:NELSON
Last Name:CROY
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 BRIAN CT
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4711
Mailing Address - Country:US
Mailing Address - Phone:707-832-6071
Mailing Address - Fax:
Practice Address - Street 1:2211 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3214
Practice Address - Country:US
Practice Address - Phone:707-443-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist