Provider Demographics
NPI:1609573849
Name:CRANNEY, DARA SANDIFER (PT, DPT, MED)
Entity Type:Individual
Prefix:DR
First Name:DARA
Middle Name:SANDIFER
Last Name:CRANNEY
Suffix:
Gender:F
Credentials:PT, DPT, MED
Other - Prefix:DR
Other - First Name:DARA
Other - Middle Name:
Other - Last Name:BLACKSTOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1613 OAKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1213
Mailing Address - Country:US
Mailing Address - Phone:540-425-7748
Mailing Address - Fax:
Practice Address - Street 1:1613 OAKWOOD ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1213
Practice Address - Country:US
Practice Address - Phone:540-425-7748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist