Provider Demographics
NPI:1821032319
Name:KRAUTNER, GREGORY (PT DPT LSSBB)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:KRAUTNER
Suffix:
Gender:
Credentials:PT DPT LSSBB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15201 LAVENHAM TER
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-1903
Mailing Address - Country:US
Mailing Address - Phone:727-804-3981
Mailing Address - Fax:
Practice Address - Street 1:810 VERMONT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20420-4745
Practice Address - Country:US
Practice Address - Phone:727-804-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052127262251X0800X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic