Gregory J. Crecelius, PTA

Individual provider Active NPI Physical Therapy Assistant · Blanchester, OH

NPI 1073744801 · NPPES record last updated Jul 28, 2009

Key facts

NPI
1073744801
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA. 02748 (OH)
Practice address
820 E Center St
Blanchester, OH 45107-1310
Phone
(937) 783-3874
Fax
(937) 783-4951
NPI assigned
Jul 28, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA. 02748OHMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA. 02748 OH Yes

Addresses

Primary practice location

820 E Center St
Blanchester, OH 45107-1310

Mailing address

820 E Center St
Blanchester, OH 45107-1310
Phone (937) 783-3874

Other providers in Blanchester, OH

All providers in Blanchester, OH · Physical Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.