Provider Demographics
NPI:1336183441
Name:CROWE, BRIAN (DPT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:CROWE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 KNOLLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-3820
Mailing Address - Country:US
Mailing Address - Phone:508-721-0000
Mailing Address - Fax:508-721-0100
Practice Address - Street 1:1 SAINT MARK ST
Practice Address - Street 2:SUITE B
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-3237
Practice Address - Country:US
Practice Address - Phone:508-721-0000
Practice Address - Fax:508-721-0100
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17492225100000X
NE2320225100000X
AZ5658225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist