Provider Demographics
NPI:1821004060
Name:SIMPSON, CRAIG ANTHONY (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:ANTHONY
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:SLATERSVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02876-0656
Mailing Address - Country:US
Mailing Address - Phone:401-762-5390
Mailing Address - Fax:401-762-5392
Practice Address - Street 1:905 VICTORY HIGHWAY
Practice Address - Street 2:
Practice Address - City:SLATERSVILLE
Practice Address - State:RI
Practice Address - Zip Code:02876-0656
Practice Address - Country:US
Practice Address - Phone:401-762-5390
Practice Address - Fax:401-762-5392
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT00946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist