Provider Demographics
NPI:1477183507
Name:CROSSFIELD, TAYLOR SMITH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:SMITH
Last Name:CROSSFIELD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 KING ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-4420
Mailing Address - Country:US
Mailing Address - Phone:571-665-6560
Mailing Address - Fax:571-665-6561
Practice Address - Street 1:4700 KING ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-4420
Practice Address - Country:US
Practice Address - Phone:571-665-6560
Practice Address - Fax:571-665-6561
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
VA2305214041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist