Provider Demographics
NPI:1891454237
Name:CRABTREE, TIMOTHY (PTA)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:CRABTREE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 JAMESTOWN HWY
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:TN
Mailing Address - Zip Code:38543-6128
Mailing Address - Country:US
Mailing Address - Phone:931-310-0738
Mailing Address - Fax:
Practice Address - Street 1:1340 N GRUNDY QUARLES HWY
Practice Address - Street 2:
Practice Address - City:GAINESBORO
Practice Address - State:TN
Practice Address - Zip Code:38562-6001
Practice Address - Country:US
Practice Address - Phone:931-268-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5249225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant