Provider Demographics
NPI:1942321880
Name:CRANE, EDWIN FORREST III (DPT)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:FORREST
Last Name:CRANE
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:NED
Other - Middle Name:
Other - Last Name:CRANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:169 LEVITTOWN PKWY STE D
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-2463
Practice Address - Country:US
Practice Address - Phone:215-377-9932
Practice Address - Fax:267-839-7203
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT017641OtherPHYSICAL THERAPY LICENSE