Provider Demographics
NPI:1790278075
Name:CROSSWELL, GREGORY B (DPT)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:B
Last Name:CROSSWELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1115 BOULDERS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:5899 BREMO RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1935
Practice Address - Country:US
Practice Address - Phone:804-285-2645
Practice Address - Fax:804-287-2786
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2020-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305212050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist