Provider Demographics
NPI:1396897930
Name:CRAINE THERAPY, LTD
Entity type:Organization
Organization Name:CRAINE THERAPY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:RUNYAN
Authorized Official - Last Name:CRAINE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:870-336-0021
Mailing Address - Street 1:3423 E HIGHLAND DR
Mailing Address - Street 2:SUITE A& B
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-6404
Mailing Address - Country:US
Mailing Address - Phone:870-336-0021
Mailing Address - Fax:870-931-5567
Practice Address - Street 1:3423 E HIGHLAND DR
Practice Address - Street 2:SUITE A& B
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6404
Practice Address - Country:US
Practice Address - Phone:870-336-0021
Practice Address - Fax:870-931-5567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT23072251P0200X
AROTR1655225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F651Medicare UPIN