Provider Demographics
NPI:1699000919
Name:MCCRAVY, CYNTHIA HAMMETT (MSR, PT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:HAMMETT
Last Name:MCCRAVY
Suffix:
Gender:F
Credentials:MSR, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 MEADOWSWEET LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 MEADOWSWEET LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5521
Practice Address - Country:US
Practice Address - Phone:864-234-8794
Practice Address - Fax:864-234-8794
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist