Provider Demographics
NPI:1881624542
Name:CRANE, ERICKA M (PT)
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:M
Last Name:CRANE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 IVY FORK DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5836
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5240 SNAPFINGER PARK DR
Practice Address - Street 2:SUITE 130
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-4059
Practice Address - Country:US
Practice Address - Phone:770-322-7003
Practice Address - Fax:770-322-7630
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52072310-009OtherBCBS OF GA