Provider Demographics
NPI:1912738329
Name:ROBERTSON, MAGGIE CRUTCHFIELD (PT, DPT)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:CRUTCHFIELD
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20347 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:540-296-4840
Mailing Address - Fax:434-509-1695
Practice Address - Street 1:12925 BOOKER T WASHINGTON HWY STE 200
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:VA
Practice Address - Zip Code:24101-3972
Practice Address - Country:US
Practice Address - Phone:540-296-4840
Practice Address - Fax:434-509-1695
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist