Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 2305202414 | VA |
NPI | 1366060451 |
---|---|
Provider Name | Dr. David Thomas Crittenden |
First Address | Winchester, VA 22602-5347 |
Second Address | Winchester, VA 22602-5347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2020 |
Last Update Date | 06/07/2020 |