Provider Demographics
NPI:1336619030
Name:CRAWFORD, RICK (LMT)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 CANYON CT
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80603
Mailing Address - Country:US
Mailing Address - Phone:719-338-8712
Mailing Address - Fax:
Practice Address - Street 1:647 CANYON CT
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80603
Practice Address - Country:US
Practice Address - Phone:719-338-8712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0017415225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist