Provider Demographics
NPI:1891093811
Name:CRUM, SHARON ANNE (PTA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANNE
Last Name:CRUM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ANNE
Other - Last Name:MCGINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:98 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-7512
Mailing Address - Country:US
Mailing Address - Phone:765-301-4642
Mailing Address - Fax:
Practice Address - Street 1:98 N 10TH ST
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-7512
Practice Address - Country:US
Practice Address - Phone:765-301-4642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003489A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant