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Mr. Thomas H Crawford
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NPI Number Detailed Information
Provider Information:
| Name: | Mr. Thomas H Crawford |
| Gender: | M |
| Provider License Number If Given: | 11357 |
NPI Information:
| NPI: | 1871587386 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 6/18/2014 |
Provider Business Mailing Address:
| Address: | 4811 S 76TH ST SUITE 401 Greenfield, WI 53220 |
| Phone Number: | 4143257741 |
| Fax Number: | 4143257753 |
Provider Business Practice Location Address:
| Address: | 4811 S 76TH ST SUITE 401 Greenfield, WI 53220 |
| Phone Number: | 4143257741 |
| Fax Number: | 4143257753 |
Provider Taxonomy:
| Primary: | 101YA0400X |
| Secondary (if any): | 101YP2500X |
| State: | WI |
