Most Relevant Information
Provider Data
| NPI Number: | 1003461823 |
| Provider Name: | CHARLO BRANDON CRUMPACKER PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 2251X0800X |
| Specialty: | Physical Therapist |
| License Number: | 63405 |
Most Important Dates
| Enumeration Date: | 08/08/2019 |
| Last Updated: | 03/09/2021 |
Provider Practice Location
1424 MOLALLA AVE
OREGON CITY
OR
970454004
Practice Location Phone/Fax
| Phone: | 5037444916 |
| Fax: |
Provider Mailing Location
1200 CORPORATE DR
HOOVER
AL
352422941
Provider Mailing Phone/Fax
| Phone: | 4236828840 |
| Fax: |