Provider Demographics
NPI:1447039003
Name:CROUSE, VALDEZ (LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:VALDEZ
Middle Name:
Last Name:CROUSE
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 BISHOP WHITE DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-1300
Mailing Address - Country:US
Mailing Address - Phone:484-424-1418
Mailing Address - Fax:
Practice Address - Street 1:1785 BISHOP WHITE DR
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-1300
Practice Address - Country:US
Practice Address - Phone:484-424-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART00522542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer