Christopher Terrill Crockett
Student in an Organized Health Care Education/Training Program in Cleveland, OH. Individual provider (NPI-1).
NPI number1982248258
StatusActive
Last updated in NPPESOct 8, 2025
Details
- NPI
- 1982248258
- Entity type
- Individual (NPI-1)
- Name
- Christopher Terrill Crockett
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 30, 2019
- Certification date
- Oct 8, 2025
- Last updated
- Oct 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | S.2504518-TRNE | OH | Yes |
Practice location
3518 W 25th StCleveland, OH 44109-1951
Phone 216-741-2241
Mailing address
3518 W 25th StCleveland, OH 44109-1951
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