Provider Demographics
NPI:1558310854
Name:CROOK, NATHANIEL M JR (PT)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:M
Last Name:CROOK
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4110
Mailing Address - Country:US
Mailing Address - Phone:610-842-9406
Mailing Address - Fax:
Practice Address - Street 1:621 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4110
Practice Address - Country:US
Practice Address - Phone:610-842-9406
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007251L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097982PQXMedicare ID - Type Unspecified