Crocker, Eddie Lee
Crocker, Eddie Lee is an individual health care provider with primary practice located at 1400 Shelby Dr , Dyersburg TN 38024-3435. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Crocker, Eddie Lee can be contacted via phone (731) 288-5056.Contact Information
Primary practice address
1400 Shelby Dr
Dyersburg TN 38024-3435
Phone: (731) 288-5056
Fax: (731) 288-5067
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT0000002313 | Tennessee |
Profile Details
NPI number | 1316978612 |
---|---|
LBN Legal business name | Crocker, Eddie Lee |
Credentials | Physical Therapist (PT) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 5th, 2006 |
Last updated | Dec 18th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1316978612 | NPPES |
Tennessee | MEDICAID | 1510385 | |
Tennessee | Other | 4039751 |
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