Provider Demographics
NPI:1528069689
Name:CROY, THEODORE WESTON III (MPT, OCS, CSCS)
Entity type:Individual
Prefix:MR
First Name:THEODORE
Middle Name:WESTON
Last Name:CROY
Suffix:III
Gender:M
Credentials:MPT, OCS, CSCS
Other - Prefix:
Other - First Name:TED
Other - Middle Name:
Other - Last Name:CROY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:251 YOUNG WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-5291
Mailing Address - Country:US
Mailing Address - Phone:912-756-3003
Mailing Address - Fax:912-315-3664
Practice Address - Street 1:230 DUNCAN DRIVE
Practice Address - Street 2:TUTTLE ARMY HEALTH CLINIC PHYSICAL THERAPY SECTION
Practice Address - City:HUNTER ARMY AIRFIELD
Practice Address - State:GA
Practice Address - Zip Code:31409-5320
Practice Address - Country:US
Practice Address - Phone:912-315-6129
Practice Address - Fax:912-315-3664
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist