Provider Demographics
NPI:1831123652
Name:STRONG, CRAIG L (PT)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:L
Last Name:STRONG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6031
Mailing Address - Country:US
Mailing Address - Phone:256-340-9708
Mailing Address - Fax:256-340-9624
Practice Address - Street 1:2506 DANVILLE RD SW
Practice Address - Street 2:SUITE 200
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-4232
Practice Address - Country:US
Practice Address - Phone:256-350-6331
Practice Address - Fax:256-350-1990
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH678225100000X
MSPT3812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1033218524OtherNPI GROUP
AL529917620Medicaid
MS09015077Medicaid
AL1003819608OtherNPI GROUP
AL1003819608OtherNPI GROUP
MSC02726Medicare PIN