Provider Demographics
NPI:1992927396
Name:CROWLEY, GRETCHEN SUE (PT)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:SUE
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MAVERICK CT
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4833
Mailing Address - Country:US
Mailing Address - Phone:540-869-5117
Mailing Address - Fax:
Practice Address - Street 1:607 E JUBAL EARLY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5178
Practice Address - Country:US
Practice Address - Phone:540-536-2328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist