Provider Demographics
NPI:1679825566
Name:CROWELL, RICHARD JOHN JR (DPT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOHN
Last Name:CROWELL
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 E. EUCLID AVENUE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-9998
Mailing Address - Country:US
Mailing Address - Phone:856-427-9311
Mailing Address - Fax:856-427-9310
Practice Address - Street 1:76 E. EUCLID AVENUE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-9998
Practice Address - Country:US
Practice Address - Phone:856-427-9311
Practice Address - Fax:856-427-9310
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA014013002251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic