Provider Demographics
NPI:1801689294
Name:CRAWFORD, FRED THOMAS IV (NRP, ATS)
Entity type:Individual
Prefix:MR
First Name:FRED
Middle Name:THOMAS
Last Name:CRAWFORD
Suffix:IV
Gender:M
Credentials:NRP, ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3016
Mailing Address - Country:US
Mailing Address - Phone:973-388-0911
Mailing Address - Fax:
Practice Address - Street 1:131 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3016
Practice Address - Country:US
Practice Address - Phone:973-388-0911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer