Provider Demographics
NPI:1770059909
Name:CRAVEN, AUSTIN (PT, DPT, ATC, CSCS)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:CRAVEN
Suffix:
Gender:M
Credentials:PT, DPT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 LISBURN RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-9230
Mailing Address - Country:US
Mailing Address - Phone:267-884-2266
Mailing Address - Fax:
Practice Address - Street 1:74 RITTENHOUSE PL
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2227
Practice Address - Country:US
Practice Address - Phone:484-413-2973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5232225100000X
PAPT027329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist