Provider Demographics
NPI:1649257155
Name:CRAWFORD, COURTNEY REX (PT)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:REX
Last Name:CRAWFORD
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 1:10592 LONGVIEW TRL
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-6164
Mailing Address - Country:US
Mailing Address - Phone:440-740-4785
Mailing Address - Fax:
Practice Address - Street 1:23811 CHAGRIN BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5555
Practice Address - Country:US
Practice Address - Phone:216-682-0413
Practice Address - Fax:216-682-0417
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT11290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4173411Medicare PIN