Provider Demographics
NPI:1649051459
Name:CREWS, DAN THOMAS
Entity type:Individual
Prefix:MR
First Name:DAN
Middle Name:THOMAS
Last Name:CREWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 GRIMES AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-1013
Mailing Address - Country:US
Mailing Address - Phone:937-776-3717
Mailing Address - Fax:
Practice Address - Street 1:1505 GRIMES AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-1013
Practice Address - Country:US
Practice Address - Phone:937-776-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care