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MR. JUSTIN B CRAIN RPT
>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1790721363
Individual Registrant:MR. JUSTIN B CRAIN RPT
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1000 FRIENDSHIP RD TALLASSEE, AL 36078-1265 US
Tel: 334-283-8032 Fax: 334-283-1136
Tel: 334-283-8032 Fax: 334-283-1136
Contact information for business:
1000 FRIENDSHIP RD TALLASSEE, AL 36078-1265 US
Tel: 334-283-8032 Fax: 334-283-1136
Tel: 334-283-8032 Fax: 334-283-1136
Registration Information:
NPI: 1790721363
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | AL | PTH4404 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| AETNA | 7981728 | AL | 01 |
| UPIN | Q57152 | AL | 01 |
| CAQH | 11507998 | 01 | |
| BLUE CROSS BLUE SHIELD | 51531618 | AL | 01 |
