Provider Demographics
NPI:1457939357
Name:CROWLEY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:CROWLEY PHYSICAL THERAPY LLC
Other - Org Name:CROWLEY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:309-322-9444
Mailing Address - Street 1:939 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MINONK
Mailing Address - State:IL
Mailing Address - Zip Code:61760-1235
Mailing Address - Country:US
Mailing Address - Phone:309-533-0528
Mailing Address - Fax:309-210-9045
Practice Address - Street 1:426 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MINONK
Practice Address - State:IL
Practice Address - Zip Code:61760-1291
Practice Address - Country:US
Practice Address - Phone:309-322-9444
Practice Address - Fax:309-210-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty