1346604311 NPI number — MRS. ANN MARIE BARTON CROWE PT DPT MS

Table of content: MRS. ANN MARIE BARTON CROWE PT DPT MS (NPI 1346604311)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346604311 NPI number — MRS. ANN MARIE BARTON CROWE PT DPT MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CROWE
Provider First Name:
ANN
Provider Middle Name:
MARIE BARTON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT DPT MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARTON
Provider Other First Name:
ANN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346604311
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 S MERAMEC AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
ST LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-430-3634
Provider Business Mailing Address Fax Number:
314-286-1473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 S MERAMEC AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-430-3634
Provider Business Practice Location Address Fax Number:
314-286-1473
Provider Enumeration Date:
04/06/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2016019331 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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