Individual provider · NPI-1

Caleb Joshua Crumpler

Kinesiotherapist · Hines, IL

NPI number1912604802
StatusActive
Last updated in NPPESFeb 10, 2023

Details

NPI
1912604802
Entity type
Individual (NPI-1)
Name
Caleb Joshua Crumpler
Sex
Male
Sole proprietor
No
Enumeration date
Feb 10, 2023
Certification date
Feb 3, 2023
Last updated
Feb 10, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
226300000X Kinesiotherapist––Yes

Practice location

5000 S 5th Ave
Hines, IL 60141-3030

Phone 708-202-8387

Mailing address

220 Scott Dr Unit 504
Hines, IL 60141-3723

Phone 601-590-2613

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