1699984849 NPI number — MRS. REBECCA CRAWFORD MCGRAIL MSPT, CSCS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699984849 NPI number — MRS. REBECCA CRAWFORD MCGRAIL MSPT, CSCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGRAIL
Provider First Name:
REBECCA
Provider Middle Name:
CRAWFORD
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSPT, CSCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUTTON
Provider Other First Name:
REBECCA
Provider Other Middle Name:
CRAWFORD
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699984849
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 HARRIS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST DOVER
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05341-4404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-809-4941
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 ROUTE 9 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05363-9526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-609-2000
Provider Business Practice Location Address Fax Number:
830-606-4028
Provider Enumeration Date:
05/22/2007

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:  1150049 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com