Provider Demographics
NPI:1801413141
Name:CRANFORD, DAVID (CPED CPOA CTPO CFO)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:CRANFORD
Suffix:
Gender:M
Credentials:CPED CPOA CTPO CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9537 CHI CHI CV
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4289
Mailing Address - Country:US
Mailing Address - Phone:901-586-5010
Mailing Address - Fax:
Practice Address - Street 1:6515 POPLAR AVE STE 112
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4878
Practice Address - Country:US
Practice Address - Phone:901-795-1776
Practice Address - Fax:901-795-1738
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPED0126224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist