# CRYOWELL PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730698556
- **Authorized official:** MR. DWIGHT ALEXANDER PEEPLES JR. (OWNER)
- **Authorized official phone:** (404) 320-0981

## Contact information

- **Practice address:** 37 BRENDAN WAY, GREENVILLE, SC 29615-3514
- **Practice address phone:** (687) 866-3646
- **Practice address fax:** (888) 651-5324
- **Mailing address:** 3842 MOURNING DOVE DR, WEDDINGTON, NC 28104-8636
- **Mailing address phone:** (404) 308-0981

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 8180 | SC | Yes |

## Other

- **Enumeration date:** 09/25/2017
- **Last updated:** 09/25/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | TH3404 | — | SC |